苏北某县乡镇卫生院基本药物制度实施现状分析

Analyzing the Status of Implementation of the Essential Medicine System in Township Health Centers in One County of Northern Jiangsu

目的:分析基本药物制度实施对欠发达地区基层医疗机构产生的影响。方法:通过发放机构调查表收集苏北某县17家乡镇卫生院2013~2015年期间相关数据资料,并结合人物访谈进行综合分析。结果:从2013年到2015年,样本县乡镇卫生院配备的基本药物品种数由872种降至666种,其中国家基本药物占比由56.77%降至54.50%;总卫生服务量有所增加,其中门诊和住院服务量年均增长率分别为46.82%和-23.86%;收入结构中主要来源是医疗收入,占比48.20%~54.20%,药占比和财政补助占比21.30%~23.00%。结论:推行基本药物制度过程中还存在国家基本药物配备使用欠缺主导地位、基本药物制度实施对住院服务有一定的抑制作用和基本药物零差率销售背景下财政补助水平偏低的问题。

Objective To analyze the influence of Essential Medicine System on grass-roots medical institutions in underdeveloped areas. Methods Data of 17 township health centers in one county of Northern Jiangsu from 2013 to 2015 was obtained by questionnaire, and analyzed based on interview. Results The kinds of medicine in sampled township health centers decreased from 872 to 666, in which the proportion of national essential medicine decreased from 56.77% to 54.50%. The amount of health services increased, in which the average annual growth rate of outpatient and inpatient services were 46.82% and -23.86%. The main source of income was medical treatment, accounting for from 48.20% to 54.20%. And the proportion of medicine and financial assistance to total income was from 21.30% to 23.00%. Conclusion There had some problems in the process of implementing the essential medicine system, mainly as lacking of dominant position of the national essential medicine, inhibitory effect on inpatient service and insufficient financial assistance under the background of zero rate of essential drugs sale.