探讨基本药物制度实行对陕西省基层医疗机构合理用药的影响

Exploration of the Effect of Implementing the Essential Medicine System on Rational Drugs Use of Primary Medical Institutions in Shaanxi Province

目的:探讨我国基本药物制度实施后对陕西省基层医疗机构合理用药的影响。方法:随机抽取陕西省20家药品试点零差价基层医院的处方600张,以及其他非试点基层医院的处方600张,比较分析国家基本药物制度实施前后处方药品品种数量均数、均次处方金额,以及使用抗生素、激素、注射剂处方比例等指标的差异。结果:所有抽取调查的每张处方药品品种数量均数和均次处方金额医院基本药物制度实施前后比较差异具有统计学意义(P<0.05);而使用抗生素、激素、注射剂处方比例在基本药物制度实施前后比较差异无统计学意义(P>0.05)。结论:国家基本药物制度的实施,能有效降低处方费用、处方药品数量,对基层医疗机构的合理用药有一定促进作用,但促进作用具有一定的局限性,应加强对基层医疗机构抗生素、注射剂的监管力度,提高合理用药率。

Objective：To explore the effects on rational drug use of primary medical institutions in Shaanxi Province after implementing national essential medicine system. Methods： The 600 prescriptions from zero-profit primary hospitals of 20 drug pilots in Shaanxi Province and 600 prescriptions from other non-pilot primary hospitals were selected randomly. The differences of such indicators as the quantity mean of prescription drugs, average pre-scription costs, and the proportion of using antibiotics, hormones, injections prescriptions before and after the imple-mentation of the national essential medicine system were compared and analyzed by statistical method. Results：In all the survey data before and after the implementation of the basic drug system, the difference in the quantity mean of prescription drugs and average prescription costs were statistically significant （P〈0.05）;However, there was no significant difference in the proportion of antibiotics, hormones and injections prescriptions before and after the im-plementation of the basic drug system（P〉0.05）. Conclusion：The implementation of the national essential drug sys-tem can effectively reduce the cost of prescription and the number of prescription drugs, and promote the rational use of drugs in primary health care institutions. However, this promotion has some limitations, it is necessary to strengthen the supervision of antibiotics and injections in primary medical institutions, and improve the rate of rational drug use.