医疗救助对象对基本药物的接受度及影响因素研究

Level of Acceptance of the Essential Drugs and Associated Factors in Medical Aid Recipients

目的探讨基本药物制度实施后医疗救助对象对基本药物的接受度及影响因素。方法于2012年8—12月,采用多阶段分层随机抽样法在山东省抽取1 700户居民进行调查。调查工具为本课题组自行设计的"国家基本药物制度居民调查表",内容包括居民基本情况、患病与就诊情况、基本药物制度认知、用药行为。共发放问卷1 700份,有效回收1 518份,涉及居民4 649例,其中医疗救助对象252例。比较不同特征医疗救助对象对基本药物的接受度,采用多因素Logistic逐步回归分析探讨医疗救助对象对基本药物接受度的影响因素。结果医疗救助对象对基本药物的接受度为85.7%(216/252)。不同居住地、文化程度、职业、收入来源及是否参加新农合医疗救助对象对基本药物的接受度比较,差异有统计学意义(P<0.05);不同性别、年龄医疗救助对象对基本药物的接受度比较,差异无统计学意义(P>0.05)。是否2周内患病、是否患慢性病及是否住院治疗医疗救助对象对基本药物的接受度比较,差异无统计学意义(P>0.05)。是否了解基本药物制度、是否信任广告及是否信任医生处方医疗救助对象对基本药物的接受度比较,差异有统计学意义(P<0.05);不同基本药物质量、基本药物疗效认知医疗救助对象对基本药物的接受度比较,差异无统计学意义(P>0.05)。多因素Logistic逐步回归分析结果显示,居住地、是否了解基本药物制度、是否信任广告、是否信任医生处方是医疗救助对象对基本药物接受度的影响因素(P<0.05)。结论医疗救助对象对基本药物的接受度较高,影响因素包括居住地、是否了解基本药物制度、是否信任广告及是否信任医生处方。可以通过增加对城乡医疗救助对象的补助,扩大基本药物制度的宣传,提高医疗救助对象对广告的认知水平及对医生处方的信任程度,来提高医疗救助对象对基本药物的接受度。

Objective To investigate the level of acceptance of the essential drugs and associated factors in medical aid recipients in China after the implementation of essential medicine system.Methods From August to December 2012,1 700 Shandong families were sampled by using stratified multistage random sampling and surveyed by a self-developed National Essential Medicine System Questionnaire for Residents,involving the demographic data,medical history,treatment history,the level of awareness of the essential medicine system,and use of essential drugs.The survey achieved a response rate of 89.3%（ 1 518/1 700）,involving 4 649 residents,of whom 252 were medical aid recipients.The level of acceptance of the essential drugs was compared between medical aid recipients grouped by demographic data.Multivariate stepwise Logistic regression analysis was performed to investigate the associated factors for the level of acceptance of the essential drugs in medical aid recipients.Results The level of acceptance of the essential drugs in the medical aid recipients was 85.7%（ 216/252）.It varied by the residence,educational attainment,occupation,source of income,and status of enjoying the benefits from New Rural Cooperative Medical Scheme（ P 0.05）,while not by sex and age（ P 0.05）.The level of acceptance of the essential drugs differed significantly in medical aid recipients by level of the awareness of the essential medicine system,degree of trust in advertisements,and degree of trust in the doctor（ P 0.05）,while it did not by the disease occurred within two weeks before the survey,chronic disease history,in-hospital treatment history,quality of the essential drugs and awareness of the efficacy of the essential drugs（ P 0.05）.Multivariate stepwise Logistic regression analysis found that,residence,level of awareness of the essential medicine system,degree of trust in the advertisements and degree of trust in the doctor were the associated factors for the level of acceptance of the essential drugs in medical aid recipients（ P 0.05）.Conclusion The level of acceptance of the essential drugs in the medical aid recipients is high,which is affected by the residence,the level of awareness of the essential medicine system,the degree of trust in the advertisements,and the degree of trust in the doctor.In order to further improve the level of acceptance of the essential drugs in this population,it is suggested to increase the subsidy,expand the publicity of essential medicine system,enhance the awareness of advertisements and advance the degree of trust in the doctor.