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目的:对社区卫生服务机构实施基本药物制度的效果进行分析,并提出建议,促进基本药物制度顺利实施。方法:选取山东省20所实施基本药物制度的社区卫生服务机构为研究对象。通过查阅文献确定本次调查的指标,即基本药物配备量、门诊工作量、门诊收入、人均医疗费用等。制定调查问卷,由调查的社区卫生服务机构方面进行填写,通过对比分析对社区卫生服务机构实施效果进行评价。结果:基本药物配备量只占基本药物目录的58.9%;门诊量和处方张数增加25%以上,但人员编制只增加5.2%;门诊费用下降24.4%,药品费用下降39.6%,人均诊疗费用下降42.9%;财政补偿增长52.6%。结论:基本药物制度初见成效,能够降低患者门诊费用,使基本医疗下沉到社区,有效引导患者进入社区卫生服务机构就诊。但基本药物配备量不足,社区卫生机构人员编制缺乏等问题突出,配套政策仍需进一步完善,并且加大推行力度。
OBJECTIVE: To analyze the effect of implementing the basic drug system by community health service agencies and make recommendations to promote the smooth implementation of the basic drug system. Methods: Twenty community health service institutions implementing the basic drug system in Shandong Province were selected as the research object. By consulting the literature to determine the indicators of this survey, that is, the amount of basic drugs, outpatient workload, out-patient income, per capita medical expenses. Make a questionnaire, fill in the survey by the community health service agencies, through the comparative analysis of community health service agencies to implement the effect of evaluation. Results: The amount of essential medicines accounted for only 58.9% of the list of essential medicines; the outpatient amount and number of prescriptions increased by 25% or more, but the staff establishment increased by only 5.2%; the outpatient expenses decreased by 24.4%; the cost of medicines decreased by 39.6% 42.9%; financial compensation increased by 52.6%. Conclusion: The initial results of the basic drug system can reduce the outpatient costs of patients, the basic medical subsidence to the community, effectively guide patients into community health services. However, there are not enough basic medicines and facilities and lack of staffing in community health institutions. The supporting policies still need to be further improved and intensified.