摘要
利用准实验对照研究方法,就新型农村合作医疗(以下简称新农合)对乡村医生处方行为的影响进行了研究。研究结果显示:新农合对乡村医生处方行为产生了很大的影响,平均每就诊人次使用药品数量、使用抗菌素的比例、使用抗菌素的数量和注射用药的比例,以及平均就诊费用等在实行新农合的村都高于没有实行新农合的村;在实行新农合的村中,乡村医生对参合人员和非参合人员的处方行为也有显著不同,证明新农合实施后加剧了农村用药不合理现象。提示:在新农合的方案设计中应注意建立相应机制,控制药品的不合理利用,同时,需要进一步加强对乡村医生的监管,规范用药行为,确保农民获得价格低廉和安全有效的卫生服务。
A quasi- experimental case-control study was conducted to assess the effects of New Cooperative Medical Scheme （NCMS） on village doctors＇ prescribing behavior in rural China. Results show that the NCMS has a strong impact on influencing the village doctors＇ prescribing behavior. The average number of drugs prescribed, the percentage of prescription using antibiotics, the number of antibiotics per visit, the percentage of patients receiving injections, and the average cost per visit are consistently different between village health stations with NCMS and without NCMS schemes. The village doctors＇ prescribing behaviour toward insured and uninsured are also significantly different. The implementation of NCMS intensified irrational drug use in village health stations. Policy implications from this study are that the NCMS should be carefully designed to create proper incentives in cost containment and service quality improvement. And more regulation for village doctors＇ prescribing behavior is needed to ensure the rural population is able to access effective care at a reasonable cost.
出处
《中国卫生经济》
2006年第4期42-44,共3页
Chinese Health Economics
关键词
乡村医生
新农合
处方行为
village doctor, NCMS, prescribing behaviour
