摘要
目的:探讨三级公立医院影响医生优先处方基本药物的重要影响因素,为综合性公立医院顺利实施基本药物制度提供参考。方法:以安徽某三级医院临床医生为研究对象,基于计划行为理论构建理论模型,采用描述性分析、多元回归分析和路径分析探讨影响基本药物优先使用的相关因素。结果:收入变化与取消药品加成的关系对医生处方基本药物的行为态度具有重要影响;医院对基本药物制度的宣教程度对医生优先处方基本药物的主观规范具有重要影响;医生对基本药物价格的了解程度、医院对基本药物制度的支持度以及优先处方基本药物绩效考评比例分别对医生优先处方的知觉行为控制、处方基本药物行为意向以及医生优先处方基本药物的实际行为方面具有重要影响。结论:调整医生收入结构、完善补偿机制、提高对基本药物制度的支持程度有利于提高基本药物在三级医院使用率,推进基本药物制度在城市医疗卫生机构的顺利实施。
Objective:To explore the important influencing factors affecting physician s essential medicine prescription in tertiary public hospitals,and to provide reference for the successful implementation of the theory of planned behavior on essential medicine in those target hospitals.Methods:Taking the physician as a research object in a tertiary public hospital in Anhui Province,and based on the theory of planned behavior,Statistical analysis was performed using descriptive analysis,multiple regression analysis,and path analysis to depict the factors influencing the essential medicine prescription.Results:The relationship between income change and abolished medicine markups played an important role in the behavioral attitude of physicians in the prescription of essential medicine;the degree of publicity was of great importance in the subjective norms(SNs)of the essential medicine system;the price of essential medicines contributed in the perceived behavioral control(PBC);the degree of support for the essential medicine system greatly influenced the behavior intention(BI);and the performance evaluation proportion of priority medicine prescription greatly positively affected the actual behavior.Conclusions:Adjusting the income structure of physicians,improving the compensation mechanism,increasing the popularization and supporting the essential medicine system in the hospital will improve the rate of essential medicine utilization in tertiary hospitals and promote a smooth implementation of the essential medicine system in urban medical institutions.
作者
周昕
张雪婷
胡旭
解雪峰
ZHOU Xin;ZHANG Xue-ting;HU Xu;XIE Xue-feng(School of Pharmacy,Anhui Medical University,Hefei Anhui 230032,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2019年第11期39-44,共6页
Chinese Journal of Health Policy
基金
国家自然科学基金(71503006)
关键词
三级公立医院
基本药物
合理用药
计划行为理论
Tertiary public hospital
Essential medicine
Rational drug ues
Theory of planned behavior
