摘要
目的:为进一步完善国家基本药物制度提供参考。方法:对某基层医院实施国家基本药物制度前后的收入结构、收支结余、药品采购情况以及医疗服务提供量等数据进行统计分析。结果:国家基本药物制度实施前、后,该院的月平均总收入、医疗收入及药品收入比较,差异均无统计学意义(P>0.05);制度实施后月平均基药收入显著高于制度实施前(P<0.05)。制度实施后该院月平均总收支结余、医疗结余以及药品结余显著低于制度实施前(P<0.05)。制度实施前该院采购金额居于前10位的药品以抗菌药物为主,共计6种;制度实施后抗菌药物排名显著下降,排名第1位的不再是抗菌药物,排名前5位中抗菌药物由4种减少到2种,且抗菌药物分级由二线转换为一线。制度实施后该院月平均门急诊人数显著增加(P<0.05),而人均费用显著下降(P<0.05)。结论:实施国家基本药物制度对该院运营产生一定影响,促进了抗菌药物合理使用,提高了医疗服务质量,降低了患者费用,但"以药补医"状况改善并不明显,且医院利润收入减少,故仍需优化基本药物政策,完善《国家基本药物目录》。
OBJECTIVE： To provide reference for further improvement of National Essential Medicine System. METHODS： The income structure, income and expenses balances, drug purchase and medical service were analyzed statistically before and after the implementation of National Essential Medicine System. RESULTS： There was no statistical significance in the monthly average total income, medical income and medicine income before and after the implementation of National Essential Medicine System （P〉0.05） ; the monthly average incomes of essential medicine after the implementation of the System was significantly higher than before （P〈0.05）. After the implementation of the system, income and expenses balance, medical balance and medicine balance were significantly lower than before （P〈0.05）. Before the implementation of the system, top 10 drugs in the list of amount mainly were antibiotics, involving 6 types. After the implementation of the system, antibiotics slipped in the rankings; the top one in the list was not antibiotics anymore. Among top 5 medicines, 4 kinds of antibiotics included decreased to 2 kinds; the types of antibiot- ics were changed into first-line from second-line. After the implementation of the system, the numbers of outpatients were increased significantly （P〈0.05）, while the cost per capita were decreased significantly （P〈0.05）. CONCLUSIONS： The operation of the hospital is influenced by the implementation of National Essential Medicine System, which promote rational use of antibiotics, im- prove the quality of medical service and reduce the cost of patients. But it doesn＇t change the situation of ＂feed the hospital with medical charges＂. Furthermore, the profit for hospital is reduced. It is suggested to optimal essential medicine policy.
出处
《中国药房》
CAS
CSCD
2014年第32期3063-3065,共3页
China Pharmacy
关键词
国家基本药物制度
管理
医院
运营
影响
National Essential Medicine System
Management
Hospital
Operation
Influence
