药品带量采购政策患者满意度及其影响因素分析

Analysis on Patients′Satisfaction with Volume-based Drug Procurement and Its Influence Factors

目的:从患者满意度的角度评价药品带量采购政策的实施效果,分析其影响因素并提出相关建议。方法:对上海市某医共体内高血压门诊的患者进行问卷调查,分析人群特征、药价满意度、政策实施后药品更换情况、中标药使用情况等对药品带量采购政策患者满意度的影响。结果:患者对药品带量采购政策的总体满意度评分为3.64分,总体满意率为72.89%,对药品带量采购政策是否满意与被调查者家庭人均月收入、对政策了解程度、对政策了解重要性的认知、门诊均次费用下降程度、是否接受更换药品等因素相关。月收入越高(OR=1.45,95%CI:1.03~2.06)、主观上越愿意接受更换药品(OR=1.99,95%CI:1.06~3.75)、对中选药同类药品价格越满意(OR=2.00,95%CI:1.13~3.54)、对政策缓解“看病贵”效果越满意(OR=2.57,95%CI:1.49~4.43)、对政策宣传普及越满意(OR=15.46,95%CI:8.68~27.52)的患者,越容易对药品带量采购政策的效果满意。结论:为改善药品带量采购政策效果,应在提高患者对中选药品的信心、降低未中选同类药品价格、扩大集中采购药品种类覆盖、控制医疗检查费用等方面下功夫。

Objective:To evaluate the effect of volume-based drug procurement from the perspective of patient satisfaction,analyze the influence factors and propose relevant suggestions.Methods:A questionnaire survey was conducted among hypertensive patients from a community medical institution in Shanghai to analyze the effects of population characteristics,the satisfaction of drug price,drug replacement after the implementation of the policy,and the use of bid-winning drugs on patients′satisfaction with volume-based drug procurement.Results:The overall satisfaction score of the patients with volume-based drug procurement policy was 3.64,and the satisfaction rate was 72.89%.The satisfaction with the policy was related to the patients′income,understanding of the policy,recognition of the importance of understanding policy,the decline of average outpatient expenses,the willingness to change medications and other factors.The higher the income(OR=1.45,95%CI:1.03-2.06),the more willing to accept drug replacement(OR=1.99,95%CI:1.06-3.75),the more satisfied with the price of the selected similar drugs(OR=2.00,95%CI:1.13-3.54),the more satisfied with the effect of the policy alleviating high expense in medical care(OR=2.57,95%CI:1.49-4.43),and the more satisfied with the policy publicity(OR=15.46,95%CI:8.68-27.52),the patients are more likely to be satisfied with the policy effect of volume-based drug procurement.Conclusion:In order to improve the effect of volume-based drug procurement policy,relevant departments should make more efforts to improve patients′confidence in the selected drugs,reduce the price of similar drugs that have not won the bid,expand the coverage of volume-based procurement drugs,and control the cost of medical examinations.