陕西省基层医疗机构药品短缺现状、造成的影响及对策研究

On Current Situation, Influence and Solution to Drug Shortage of Primary Medical Institutions in Shaanxi Province

目的:调查和探讨陕西省基层医疗机构药品短缺现状、造成的影响和对策,为保障药品供应提供依据。方法:采用自行设计的药品短缺调查问卷,于2017年3-6月期间对陕西省基层医疗机构的全科医生进行调查。问卷内容包括基本信息、药品短缺现状、影响和应对策略等4个部分。结果:共发放问卷235份,回收有效问卷193份,有效回收率为82.1%。其中,92.1%的全科医生曾遇到药品短缺情况,短缺品种数共为139种,不同医疗机构和不同经济发展水平地区短缺情况存在差异;短缺药品一般为低价药和基本药物,种类覆盖面较广,其中呼吸系统用药、心血管系统用药短缺较为严重;药品短缺主要给医生的工作带来不便,影响医患关系,影响医院的声誉以及增加了患者经济负担;为应对药品短缺问题,大部分全科医生对患者使用次优疗法或替代药物。结论:陕西省基层医疗机构药品短缺现状比较严峻,影响了医务人员的日常工作,增加了患者治疗负担。建议政府部门加强对药品短缺的监测,强化政策引导,建立针对药品供应企业的奖惩制度。

Objective： To investigate and explore the current situation, influence and solution to drug shortage in primary medical institutions in Shaanxi Province in order to provide references for ensuring drug supply.Methods： A self-designed questionnaire survey was used to investigate general medical practitioners of primary medical institutions in Shaanxi Province from March 2017 to June 2017. The questionnaire consisted of four parts： basic information, current situation, influence and solution to the drug shortage. Results： A total of 235 questionnaires were distributed and 193 valid questionnaires were received, with an effective recovery rate of 82.1%. 92.1% of general medical practitioners reported that they had experienced drug shortage. A total of 139 kinds of drug were in shortage differently in different medical institutions and with different levels of economic development. The drugs in shortage were generally low-cost and essential drugs, with broader kinds, cardiovascular and pulmonary drugs being more serious. Drug shortage could affect the routine work of the doctors, worsen doctor-patient relationship and reputation of hospitals, and increase the economic burden of patients. Suboptimal therapies or alternative drugs were used to cope with the drug shortage. Conclusion： The current situation of drug shortage in primary medical institutions in Shaanxi Province was serious. It was suggested that government departments should strengthen the monitoring of drug shortage and establish system of rewards and punishments for drug supply enterprises.