浙江省33家县级公立医院对基本药物制度的认知评价调查

Awareness Evaluation and Analysis of Essential Medicine System in 33 County Public Hospitals of Zhejiang Province

目的:评价县级公立医院医师和药师对基本药物制度的认知态度及行为,分析影响因素,提出建议与对策。方法:采用随机分层抽样法对浙江省33家县级公立医院的医师和药师进行基本药物制度知识-态度-行为(KAP)问卷调查,内容包括对基本药物制度的认知、态度,执行基本药物制度中的相关行为和影响因素,以及实施过程中存在的问题及对策。结果:共发放问卷320份,获得有效问卷290份,有效应答率为90.6%。对基本药物制度及政策整体认知的总体得分为(3.48±0.96);不同职称、职务、医院等级及类别者认知水平存在显著差异(P<0.05)。对实施基本药物制度总体态度的平均得分为(16.8±2.49),得分最高的是能减轻群众医药负担,最低的是实施效果令人满意;75.9%的受访者认为制度执行较好的是宣传培训,47.9%的人认为配备目录不能满足临床需求。86.6%的受访者认为实施过程中存在部分急救和常用药品采购困难,59.0%的人认为医师使用积极性不高,最应该完善的是供应配套体系,及提高药品质量层次。结论:医师和药师对基本药物制度的认知水平中等,实施效果满意度较低,实施过程存在的问题有待于完善。建议政府部门和医院加强政策落实,完善激励和约束机制,进一步推进基本药物制度在县级公立医院的实施。

Objective：To evaluate the knowledge, attitudes and practices （ KAP ） of essential medicine system by physicians and pharmacists from county public hospitals, analyze the influence factors, and put forward some sugges- tions. Methods： A random stratified sampling method was used to take the questionnaire survey of the physicians and phar- macists from 33 county public hospitals in Zhejiang, regarding the basic medicine system of knowledge, attitude and prac- tice （KAP）. Content includes cognition, attitude towards the basic drug system, related behavior and influence factors when executing essential drug system, as well as the exist problems and countermeasures during the process of implemen- ting. Results ：290 valid questionnaires were collected with valid answering rate 90.6%. The score was （3.48 ＋ 0.96） for the overall cognition of national essential drug system, among which different professional title and post, rank of the hospi- tals showed a significant difference （ P 〈 0.05 ）. And it was （ 16.8 ＋ 2.49） scores of the general attitude for the implemen- tation. The highest score was reducing the medical burden on patients, and the lowest score was the satisfaction of imple- mentation effect. The better system execution was the pubticityand training approved by 75.9% of the respondents. 47.9% of the respondents thought that the drug list equipped could not satisfy clinical requirements, 86.6% thought that the purchase difficulty for some of the emergency medicines and the regular medications existed in implementation process, and 59.0% thought that the initiative of the physicians were not high and what we should do was to provide the supported systems and improve the quality of medicines. Conclusion：The cognition of the basic drug system by the physicians and pharmacists was in the middle level, which was lower in the satisfaction of implementation. The problems about the imple- mentation had yet to be perfect. The government departments and hospitals should strengthen the implementation of policy, perfect motivation mechanisms and restrictive mechanisms, promote the active use of essential drugs in the county public hospitals.