南京市各级医疗机构用药结构和用药衔接性研究

Study on the Structure and Coherence of Drug Use in Medical Institutions at All Levels in Nanjing

利用药品ATC一级分类方法,统计各级医疗机构在药品采购类别上的差异,并对其药品消费结构、金额进行对比和分析。结果显示:三级医疗机构药品使用种类更为齐全;各级医疗机构在系统用抗感染药、心血管系统用药等药品上花费的采购金额都较多,但在用药层次上存在明显差异,用药衔接性存在一定问题;基层医疗机构用药结构存在局限,限制了基层医生的用药选择。建议进一步落实"放宽基层医疗机构配备使用基本药物目录外、医保目录内药品"的政策,对各级医疗机构制定不同的药品目录,同时适度放宽基层医疗机构的医保报销政策,以提升基层医疗机构用药层次,进一步加强基层医疗机构与二三级医疗机构的用药衔接性。

Using the ATC primary classification method of drugs,medical procurement information items of the sample medical institutions were summarized,and the differences of drug procurement categories at all levels of medical institutions were counted,and the drug consumption structure and amount were compared and analyzed in this paper.The results showed that the types of drugs used in tertiary medical institutions were more diverse;the medical institutions at all levels spent much on the use of anti-infective drugs,cardiovascular drugs and other drugs with significant differences in the level of drug use.It was recommended to further implement the policy of“relaxing the use of essential medicines in primary health care institutionsand medicalinsurance catalogue”,toformulate differentdrug catalogue formedicalinstitutionsatalllevels,and to appropriately relax the medical insurance reimbursement policies of primary medical institutions to upgrade primary medical institutions,to fur原therstrengthen the connection ofmedicinesbetween primary medicalinstitutionsand secondaryandtertiary medicalinstitutions