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目的调查分析2013年,惠州市三级医院、二级医院及基层医疗卫生机构基本药物配备、采购和使用情况,为国家、省制定实施基本药物制度政策和调整基本药物品种提供依据。方法采用随机抽样的方法,抽取惠州市2家三级医院、6家二级医院和27家基层医疗卫生机构基本药物使用情况,对基本药物配备品种、销售金额及床位数、门诊量、住院量、常见疾病进行统计分析,对在用国家、省基本药物和需增补药品品种进行筛查和遴选。结果惠州市二、三级医院基本药物可获得性在35%左右;基层医疗卫生机构尚未100%实施基本药物制度和配备基本药物;目前国家基本药物和省增补品种,约1/3未列入各级医院用药目录,主要是中成药。约50%的二级医院和基层医疗卫生机构存在已采购但连续3个月或以上未使用的基本药物品种约50种。此外,78%的基层医疗卫生机构提出需增补药品品种的需求。结论通过“零差率”销售、提供医疗保险报销比例、纳入绩效考核等方式,进一步推动国家基本药物制度扩大实施范围。国家基本药物和省增补品种无法完全满足改革后基层医疗卫生机构的用药需求,需制定合理的基本药物遴选及更新机制,并保障基本药物及增补品种的生产、采购和供应。
Objectives To investigate and analyze the allocation, procurement and use of essential medicines in tertiary hospitals, secondary hospitals and primary health care institutions in 2013 in Huizhou and provide the basis for the formulation of policy and adjustment of essential medicines by the state and the province. Methods A random sampling method was used to extract the use of essential medicines from two tertiary hospitals, six secondary hospitals and 27 primary health care institutions in Huizhou City. The basic medicines were provided with the varieties, sales amount, bed number, outpatient service volume, hospitalization rate , Common diseases, statistical analysis of the use of national and provincial basic drugs and need to supplement the drug varieties for screening and selection. Results The availability of basic medicines in Grade II and III hospitals in Huizhou City was about 35%. The primary medical institutions were not yet 100% implementing basic medicines and basic medicines. At present, about one third of the national essential medicines and supplementary varieties in the province were not included At all levels of hospital medication directory, mainly proprietary Chinese medicines. About 50% of second-tier hospitals and primary health care institutions have approximately 50 kinds of essential medicines that have been procured but have not been used for three consecutive months or more. In addition, 78% of primary health care institutions put forward the need to supplement the variety of medicines. Conclusion Through the “zero margin” sales, medical insurance reimbursement ratio, included in the performance appraisal, etc., to further promote the implementation of the national basic drug system to expand the scope of implementation. National essential medicines and supplementary varieties of provinces can not fully meet the demand for medication of primary medical and health institutions after the reform. Proper basic drug selection and updating mechanisms need to be formulated and the production, procurement and supply of essential medicines and supplementary varieties guaranteed.