国内外居家药学服务现状及补偿机制探讨

Discussion on the current situation and compensation mechanism of home-based pharmaceutical service in China and abroad

目的:了解国内外居家药学服务现状,总结国外较好的居家药学服务经验和服务补偿方式,为国内开展该项工作提供借鉴。方法:选取国内药学服务开展具有代表性和先进经验的地区中若干所二级和三级医院发放问卷,了解国内居家药学服务开展情况;通过文献研究了解国外居家药学服务开展现状及补偿情况。结果:国内居家药学服务开展率低;在调研的143所国内医疗机构中,均未对居家药学服务进行收费。国外居家药学服务开展较成熟,部分国家通过让药师参与家庭医生签约或将药学服务费纳入医保的方法进行药学服务补偿。结论:应提高居家药学服务人员的资质,提高专业能力;政府及相关部门给予充分支持,探索居家药学服务的补偿方式,提高公众认知感,循序渐进地改善居家药学服务,以提高国民健康水平。

Objective:Questionnaire survey on the current situation of home-based pharmaceutical care in China,combined with literature research at home and abroad,learned the good pharmaceutical care experience and the reimbursement means abroad,to provide reference for this work in China and improve the level and quality of home-based pharmaceutical care.Methods:Several secondary and tertiary hospitals with representative and advanced experience in the development of pharmaceutical care were selected to issue questionnaires to understand the development of home-based pharmaceutical care,and the current situation and compensation mechanism of home-based pharmaceutical care at home and abroad were studied in combination with literature.Results:Home-based pharmaceutical care is the lowest among all pharmaceutical work in China,with a rate of 9.2%in tertiary hospitals and 3.8%in secondary hospitals.In the sample,no hospitals from the western region offered the service.In the 143 medical institutions investigated,none of them charged for home-based pharmaceutical care.Overseas community pharmaceutical care is more mature than that in China.In some countries,pharmacists obtain some prescribing rights by signing contracts,and some countries will take pharmacists to participate in the contract making of family doctors or include pharmaceutical service fees into medical insurance to compensate for pharmaceutical care.Conclusions:It is necessary to improve the qualification and professional ability of home-based pharmaceutical service personnel,and the government and relevant departments should give full support,explore the compensation means of home-based pharmaceutical service,improve public awareness,improve community pharmaceutical care step by step,and improve the national health level.