西安市基层医疗机构实行国家基本药物制度状况分析

Effects of national essential medicine system on primary medical institutions in Xi'an

目的分析梳理西安市2010—2013年基层医疗机构临床用药相关数据、指标及变化,总结国家基本药物制度在基层医疗机构推行的效果和问题,为政策进一步落实和推进提供参考。方法本研究回顾了3年来西安市基层医疗机构相关统计报表、处方等资料,相关数据录入EXCEL数据库,运用SPSS17.0进行分析,研究药品配备品种数量、药品收入、药占比、处方金额、门急诊次均药品费用、住院次均药品费用、门急诊输液处方、激素使用处方、抗菌药物处方比例等。结果西安市基层医疗机构门诊人次增长25.56%、住院人次下降12.00%、医疗收入17.16%、药品收入总体增长30.51%,次均医疗费用门诊下降2.89%、住院增加15.05%,次均药品费用门诊增长6.99%、住院增长29.78%,2013年每份处方平均药物种类为2.79种,抗菌药物处方、激素处方、输液处方比例为28.80%、1.19%、21.18%,总体渐趋合理。结论国家基本药物制度实施效果初步显现,药品配备和使用渐趋合理,每处方平均药物种类、抗菌药物、激素、输液处方等指标进一步改善。建议同步推进综合医改措施、加强基层医疗机构药学学科建设、制定完善相关考核监管措施、强化培训和宣传等。

Objective To analyze the related data, clinical indicators and changes of basic medical institutions during 2010-2013, to summarize the effects and problems of the National Essential Medicine System, and to provide reference for further implementation of the policy. Methods The relevant statistical forms and prescription data of grassroots medical institutions in Xi＇an in the past 3 years were retrospectively reviewed with SPSS17.0 software. The variety of drugs, drug income, percentage of drugs, sum of prescriptions, drug costs in outpatient, emergency and hospitalized treatment, prescription of infusion, hormone and antimicrobial drugs were analyzed. Results The number of outpatients, medical income and drug income grew by 25.56%, 17. 16%, and 30.51%, respectively. The number of inpatients decreased by 12%. The average outpatient expenditure decreased by 2.89 %, hospitalization costs increased by 15.05%, outpatient drug costs increased by 6.99%, hospitalization drug costs increased by 29.78%. The average prescription drugs in 2013 was 2.79. The prescription of antibiotics, hormones and infusions was 28. 80%, 1. 19% and 21. 18%, respectively, which was rational. Conclusion The National Essential Medicine System has positive effects. The use of drugs is more reasonable. The ratios of antibiotics, hormones and infusions have been improved. More efforts are needed to further implement the system.