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目的了解昆明市各级党政干部、合管办工作人员、定点医疗机构医务人员和参合农民对新型农村合作医疗(新农合)的药品与市场同价的满意程度,为建立全面、协调、可持续发展的新农合药品制度提供科学的参考依据。方法分层和单纯随机抽取各种相关人群,对新农合药品满意度进行问卷调查,并进行统计学分析。结果4种人群对新农合定点医疗机构药品价格的满意度构成间差异有统计学意义(P<0.001);参合农民不满意率最高,达43.1%;医务人员很满意率最高,达22.4%。除药价下调可真正减轻医疗负担、对新农合满意度与药品满意度呈正相关外,地区、家庭的经济情况、与参合前相比药品的价格、药费在医疗负担中的比重、门诊或住院中药费占的比重6个因素均与对药品满意度呈负相关(P<0.05)。结论新农合药品与市场同价可减轻农民的医疗负担,拉动农村地区的医疗需求,减少药品的不正当竞争行为,减少不良的医疗行为,提高参合农民对新农合制度的信心。建议设立综合管理机构、制定定点药店标准、加快“两网”建设、适当扩大基本用药目录、提高农民的用药知情权及自主选择权。
Objective To understand the degree of satisfaction with the same price of drugs and market of new rural cooperative medical system (NRCMS) among Kunming party and government cadres at all levels, staff of joint management office, medical personnel of designated medical institutions and participating farmers, and to establish a comprehensive, coordinated, Sustainable development of new rural cooperative medical system to provide a scientific basis for reference. Methods Stratified and simply randomly selected all relevant groups of people, satisfaction survey of the new rural cooperative medical patients were conducted, and statistical analysis. Results There was significant difference (P <0.001) in the satisfaction of drug prices among the four groups of new rural cooperative medical institutions (P <0.001). The dissatisfaction rate of participating peasants was the highest (43.1%), and the satisfaction rate of medical staff was the highest (22.4% . In addition to the drug price reduction can really reduce the medical burden, the satisfaction of the new rural cooperative medical care and drug satisfaction was positively correlated, the economic situation of the region, the family, compared with the pre-participation of the drug prices, the proportion of medical expenses in the out-patient Or the proportion of Chinese medicine in hospital accounted for the proportion of six factors were negatively correlated with drug satisfaction (P <0.05). Conclusions The same price of NRCMS and the market can reduce the medical burden on farmers, stimulate the medical demand in rural areas, reduce the unfair competition of medicines, reduce the bad medical behaviors and increase the farmers’ confidence in NRCMS. It is proposed to set up an integrated management agency to set the standards of designated pharmacies, speed up the construction of “two networks”, properly expand the catalog of essential medicines and improve the farmers’ right to information and the right of independent decision-making.