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目的通过预调查了解成都市部分基层医疗卫生服务机构(三圈七院六站)药品管理、配送和监督网络情况,为循证建立成都市基层基本药物制度,保障药品供应提供证据。方法由经培训的研究人员采用访谈法调查成都市7个乡院/中心和6个村站药品配送情况和农村药品配送和监督网络(简称“两网”)建设情况,实地调查药房药品购销记录和药房环境;并与欧美发达国家药品分类管理、每千人药房数量和药剂师执业情况比较。结果①除人和卫生院因搬迁致药品管理资料遗失外,预调查的7个乡院/中心均有药品购销记录,并设有专人和设备养护在库药品。②仅3家药房使用电子药品数据库,数据库稳定性和功能有待加强。③预调查的5个乡院和5个村卫生站均通过农村药品配送和监督网络,实现药品每周1次的统一配送,保证了农村药品可及性。城市社区卫生服务中心药品配送基于传统的商业流通渠道,每周配送3次。村卫生站存在药品记录缺失,药品陈列不规范的问题。结论建议开发稳定可靠的药房电子信息管理系统,结合当地疾病负担和当前最佳证据制定乡院和村站的基本药物目录,加强乡院/中心对卫生站的指导、监督,规范卫生站药品管理,加强农村药品配送和监督网络建设,保障基本药物的供应。
Objective To investigate the network of drug administration, distribution and supervision in some primary health care institutions in Chengdu (three circles and seven hospitals and six stations) through pre-investigation to provide evidence for the establishment of basic primary drug system in Chengdu and the guarantee of drug supply. Methods Interview methods were used by trained researchers to investigate the distribution of medicines in seven townships / centers and six village sites in Chengdu and the construction of a rural drug distribution and supervision network (“Two nets”), and to conduct field investigation of pharmacy drugs Sales records and pharmacy environment; and with the developed countries in Europe and the United States drug classification management, the number of pharmacies per thousand and pharmacists practice comparison. Results ①In addition to the loss of drug management data due to relocation of people and hospitals, the seven townships / centers pre-surveyed recorded purchase and sale of drugs and provided special personnel and equipment for the maintenance of drugs in the store. ② only 3 pharmacies use electronic drug database, the database stability and function needs to be strengthened. ③ The 5 township hospitals and 5 village health stations pre-surveyed passed the rural drug delivery and supervision network to realize the unified distribution of medicines once a week, ensuring the availability of rural medicines. City community health center drug delivery based on the traditional commercial distribution channels, delivery 3 times a week. Village health station there is a lack of drug records, drug display is not standardized. Conclusion It is suggested that a stable and reliable pharmacy electronic information management system should be developed to combine with the local disease burden and the current best evidence to establish the catalogs of essential medicines for township and village hospitals and strengthen the guidance and supervision of the township hospital / , Strengthen rural drug delivery and supervision network construction, and ensure the supply of essential medicines.