泸州市基层医师对国家基本药物制度的认知与行为调查

Investigation on Recognition and Behavior of Primary Physicians to National Essential Medicine System in Luzhou

目的:为进一步推动国家基本药物制度的实施和完善提供参考。方法:采用分层随机抽样法抽取四川省泸州市的252名基层医师,就其对国家基本药物制度的认知与行为进行问卷调查,并就相关调查数据进行统计和分析。结果:共发放问卷252份,回收有效问卷243份,有效回收率为96.4%。242名听说过国家基本药物制度的受访者中选择"听说过但不清楚"的比例最高(占52.1%);149名参加过国家基本药物知识培训或学习的受访者中仅参加过"1次"的比例最高(占57.0%);受访者对国家基本药物制度各项常识的知晓率最高为45.0%,最低为16.5%。实施国家基本药物制度后,受访者中经常向诊疗对象宣传国家基本药物制度的仅占23.1%,工作积极性、工作效率、工作量选择"没有变化"的比例最高(均占58.3%),认为对临床用药习惯的"影响不大"的比例最高(占38.8%);受访者中86.4%愿意优先考虑使用国家基本药物,排在前4位的原因依次是"可以获得有关基本药物使用的培训和指导""规定了基层医疗卫生机构基本药物的使用率""国家基本药物制度的宣传力度加大""定期评价医师的处方",而13.6%不愿意优先考虑使用国家基本药物,排在前4位的原因依次是"缺乏使用基本药物的信心""基本药物可及性太差""担心因处方基本药物出现医疗事故,引发医疗纠纷""不知道哪些是基本药物"。结论:泸州市基层医师对国家基本药物制度的认知和贯彻落实有待进一步加强,这与其参与国家基本药物知识培训或学习的次数较少且效果不明显有关,同时也与政府的相关配套政策不完善有一定关系。

OBJECTIVE： To provide reference for further implementation and perfection of National Essential Medicine System. METHODS： Stratified random sampling method was used to select 252 doctors from Sichuan Luzhou. Questionnaire survey was performed among them about recognition and behavior of them to National Essential Medicine System. Related investigation data was analyzed statistically. RESULTS： A total of 252 questionnaires were issued and 243 valid questionnaires were collected with effective recovery rate of 96.4%. Of 242 respondents who had heard of National Essential Medicine System, the respondents who had heard but not clear occupied the highest percentage （52.1%）. Of 149 participants who had participated in national essential medicine knowledge training or study, the proportion of “only one knowledge training or study” was the highest （57.0%）. The survey respondents had a maximum of 45.0% and a minimum of 16.5% of common sense about National Essential Medicine System. After the implementation of National Essential Medicine System, respondents often propagandized National Essential Medicine System to diagnosis and treatment objects accounted for only 23.1%. The proportion of “no change” chosen for items of work motivation, work efficiency and workload was the highest （all occupied 58.3%）; the proportion of “little influence” chosen for item of clinical medication habit was the highest （38.8%）. 86.4% of respondents were willing to give priority to the use of national essential medicines; the top 4 reasons were “to obtain training and guidance on the use of essential medicines” “to set utilization rate of essential medicines in primary health care institutions” “to strengthen the propaganda of National Essential Medicine System” “to evaluate physician’s prescriptions regularly”. 13.6% were not willing to give priority to the use of national essential medicines; the top 4 reasons were “lack of the confidence of the use of national essential medicines” “poor accessibility of essential medicines” “fear of medical accidents due to prescription essential medicines, lead to medical disputes” “don’t know what is essential medicine”. CONCLUSIONS： The primary physicians’ perceptions of National Essential Medicine System and the implementation of the System in Luzhou need to be strengthened. The main reason is that few national essential medicine knowledge training or study and poor effects. That the government’s supporting policy is not perfect may be one of reasons.