摘要
目的通过对医改前后肥西县乡镇卫生院用药合理性的调查,为进一步建立健全基本药物制度提供参考。方法采用随机抽样的方法抽取8家肥西县乡镇卫生院,再分别从8家乡镇卫生院2009年10月和2010年10月的全部电子处方(包括急、门诊处方和住院处方)中各随机抽取100张处方。采用WHO推荐的合理用药调研的部分国际指标及自设指标分析用药的合理性。结果综合8家乡镇卫生院总体情况,与医改前(2009年)相比,医改试点后(2010年)每次就诊平均药费由60.1元下降到31.0元,具有统计学差异(P<0.01);单张处方平均用药品种数由3.8种下降到3.6种;每百例次就诊使用抗菌药物的比例均较高,分别达71.3%和69.6%;每百种处方用药中,基本药物使用率由59.4%上升到67.6%;基本药物费用占处方药物费用的百分率由43.6%上升到50.4%;每百例次就诊使用注射剂的比例由56%下降到46.1%;每百例次就诊中中成药使用比例由32.8%上升到37.9%,中药注射剂使用比例由6.1%上升到7.1%;每百例次就诊使用激素类药物的比例由24.5%下降到20%。结论实施医改后,药品价格显著下降,但在整体水平上,各乡镇卫生院之间用药水平参差不齐,不合理用药现象依然存在。
Objective In order to provide reference on further establishing the perfect essential medicines regime based on the investigation about the rationality of drug use in Feixi township hospitals before and after the medical reform.Methods Using the method of sampling investigation,author surveyed 8 township hospitals,each hospitals are draw-out 100 prescriptions randomly from all electronic prescriptions in October 2009 and October 2010,including emergency,outpatient and inpatient prescriptions.The results were analyzed by using the part of SDUIs（Selected Drug Use Indicators） developed by WHO and the self-design indicators.Results Totally,comparing with before the medical reform（in 2009）,the average expenses dropped from 60.1 to 31.0 after the medical reform（in 2010）,with significant differences（P0.01）：the drug varieties dropped from 3.8 to 3.6 in single prescription：the rate of using antibiotic drugs highly amount to 71.3% in 2009 and 69.6% in 2010 per hundred cases respectively：the rate of using essential medicines rose from 59.4% to 67.6% in every 100 prescriptions：the percentage of essential medicines costs accounted for prescription medicines costs rose from 43.6% to 50.4%：the rate of using injections dropped from 56% to 46.1% per hundred cases：the rate of using proprietary Chinese medicines rose from 32.8% to 37.9% per hundred cases,the rate of using proprietary Chinese medicine injection rose from 6.1% to 7.1% per hundred cases：the rate of using hormone dropped from 24.5% to 20.0% per hundred cases.Conclusion After the implementation of the medical reform,drug prices dropped significantly,but,totally,the phenomenon of irrational drugs use were still serious,there were some differences on the drugs use in various township hospitals.
出处
《安徽医药》
CAS
2012年第2期256-258,共3页
Anhui Medical and Pharmaceutical Journal
基金
2011年安徽省科协学会学术活动立项项目
关键词
乡镇卫生院
医改
基本药物
药品价格
合理用药
township hospitals：medical reform：essential medicines：drug prices：rational drug use
