基层公立医院患者对药品带量采购政策认知的调查分析

Investigation on the Cognition of Patients to the Volume-based Procurement Policy in Primary Public Hospitals

目的了解基层公立医院的患者对带量采购政策的态度、使用后的感受及影响患者对该政策感知及实际体会的影响因素,以期为后续政策的实施与推广提供基础依据和政策建议。方法设计调查问卷,对成都市5家基层公立医疗机构试点医院的患者进行调查,并运用SPSS软件对数据进行分析。结果共收集266份有效问卷,男性和女性分别占48.87%和51.13%。患者对带量采购政策的知晓率为56.77%;对带量采购政策的支持率为83.08%。有53.01%的受访者会因为药品价格低廉而担心药品质量;有76例(28.57%)服用过带量采购的药品,其中有50.00%的患者认为带量采购的药品与原来的同类药品相比疗效相差不大,同时59.21%的认为药物副作用方面“无差别”。68.42%的服药患者认为政策实行后总体医疗费用的下降程度明显降低。77.63%的用药患者遇见过缺药的情况,且与用药时间长短有关,差异有统计学意义(P<0.05)。结论药品带量采购政策施行效果较好,患者满意度较高;但是患者对政策的认知度有待提高,应加强宣传力度;公众对仿制药的质量信心不足。建议谨慎合理地制定药品价格,常态化抽检中选药品并及时公布检查结果。同时,需要各方加强沟通,完善制度,协商处理好缺药的问题。

OBJECTIVE To understand the attitude of patients on the policy of purchasing drugs with quantity,and their feelings after use,and the influencing factors of patients′perception and the practical experience of the policy,so as to provide the basis and suggestions for the implementation and promotion of the follow-up policy.METHODS A questionnaire was designed to investigate the patients,and the data were analyzed by SPSS software.RESULTS A total of 266 valid questionnaires were collected,48.87%of them were male and 51.13%were female.The awareness rate about the policy was 56.77%;83.08%of the respondents supported the policy.53.01%of them worried about the quality of drugs because of the low price;76 people(28.57%)had taken the volume-based procurement drugs.Among them,50%patients thought that the efficacy of the volume-based procurement drugs was not different from the non-volume-based procurement drugs,and 59.21%thought that there was“no difference”in the side effects.77.63%of the patients met the situation of drug shortage,and the longer the medication time,the higher the frequency,the difference was statistically significant(P<0.05).CONCLUSION At present,the implementation effect of the volume-based procurement policy is good,and the patients′satisfaction is high.However,patients′awareness of the policy needs to be improved,and publicity should be strengthened;The public lacks confidence in the quality of generic drugs.It is suggested that the price of drugs should be carefully and reasonably set,the selected drugs should be regularly sampled and the inspection results should be published in time,so as to enhance the public′s confidence in generic drugs.At the same time,all parties need to strengthen communication and negotiate to deal with the problem of drug shortage.