北京市社区居民用药行为影响因素分析  

Influential Factors to Medication Behavior of Community Residents in Beijing

作　　者：刘妤 许建 刘温文[2] 王亚东[2] 

机构地区：[1]北京市陶然亭社区卫生服务中心,100052 [2]首都医科大学卫生管理与教育学院

出　　处：《中国全科医学》2011年第4期410-413,共4页Chinese General Practice

基　　金：首都医学发展科研基金<社区药品政策对居民用药行为的影响研究>(2007-3198)

摘　　要：目的对北京市社区居民日常用药行为的影响因素进行分析,并根据其中的关键因素提出对策和建议。方法采用分层随机抽样的方法,对1 260名"零差率"政策实施前后均在社区卫生服务站就诊的慢性非传染性疾病(慢病)患者进行问卷调查。调查患者用药行为中日常就诊取药地点意愿及流向变化,换用"零差率"药品的行为以及引起上述行为发生变化的原因等内容。结果 29.7%的社区居民就诊地点由大医院转向社区卫生机构,就诊流向变化的主要影响因素包括年龄、教育程度、月人均收入以及药品价格。84.4%的居民就诊偏好为社区卫生机构,其主要影响因素是药品价格。在常用药不属于"零差率"药品的社区慢病患者中仅有37.8%的人在政策实施后换用了"零差率",其更换零差率药品的两个主要原因分别是社区医生建议(67.5%)和药品价格降低(60.3%);而未更换"零差率"药品的首要原因是药品种类不全(84.6%)。结论北京市社区卫生政策中各项改革措施,特别是社区药品"零差率"销售政策对居民就诊流向变化,就诊意愿以及换用"零差率"药品等日常用药行为均产生一定影响。尽快丰富社区药品种类,进一步降低药品销售价格以及加强社区医生队伍建设,提高人员整体素质是北京市未来社区卫生工作的关键点和着力点。Objective To analyze influential factors of community residents′medicine-taking behavior in Beijing,and give some suggestions and countermeasures for the key factors. Methods Totally 1 260 patients with chronic non-communicable diseases,who sought for medical care in the community health service centers around the implementation of ＂Zero-Profit＂ drug sale policy,were enrolled by using stratified random sampling.A questionnaire survey was conducted among them,including behavior changes of intention and current to go to doctor and to get drugs,and change of taking ＂Zero-Profit＂ drugs instead of using ＂non-Zero-Profit＂ ones,as well as causes and contents of these behavior changes. Results Some 29.7% of the community residents changed their place of seeing doctors from a larger hospital to a community health service（CHS） institution;the main influential factors for the change were the age,education background,monthly average income per capita and medicine price.Some 84.4% preferred CHS institution for their visits and the main influential factor was medicine price.Some 37.8% of the chronic disease patients whose commonly-used drugs belong to ＂non-Zero-Profit＂ changed to take ＂Zero-Profit＂ drugs,for which community doctor′s suggestion（67.5%） and lower medicine price（60.3%） were the two main reasons.On the other hand,the chief reason of refusing to change drugs was medicine incomplete categories of drugs（84.6%）. Conclusion The reform measures of community health policy in Beijing,especially ＂Zero-Profit＂ drug sale policy,have exerted a certain influence on the medication behaviors of community residents such as the visit current,intention for seeing doctor and change to take ＂Zero-Profit＂ drugs.It is the key points of future task for CHS works in Beijing to enrich the drug categories as soon as possible,reduce further the price of sale drugs,strengthen the team construction of community doctors,and improve the overall quality of the medical staff.

关 键 词：用药行为 社区居民 影响因素 

分 类 号：R197[医药卫生—卫生事业管理]