北京市社区卫生服务机构基本药物“零差率”政策对农村糖尿病患者治疗费用的影响  

Influence on the policy of "Without Added Profit" for basic pharmaceuticals of community health service organization on medical costs of rural diabetic patients in Beijing

作　　者：杜娟[1] 徐俊杰 邵爽[3] 于海兰 王慧丽[1] 赵亚利[1] 路孝琴[1] 郭爱民[1] 刘绍杰[1] 

机构地区：[1]首都医科大学公共卫生与家庭医学学院,北京100069 [2]北京市房山区韩村河镇社区卫生服务中心,北京102423 [3]首都医科大学燕京医学院,北京101300

出　　处：《中国医药导报》2012年第35期134-136,共3页China Medical Herald

基　　金：北京市哲学社会科学"十一五"规划项目(项目编号:09BaSH049)

摘　　要：目的通过建立计量经济学模型估计基本药物"零差率"政策实施前后对于北京市农村地区糖尿病患者治疗费用的影响。方法采用典型抽样在北京房山区和大兴区各抽取一个社区卫生服务中心,随机抽取"零差率"政策实施前后糖尿病患者处方,房山某社区卫生服务中心政策实施前糖尿病患者处方140份,政策实施后处方200份,大兴某社区卫生服务中心只有政策实施后处方200份。结果房山某社区卫生服务中心政策实施后糖尿病患者次均处方药品个数由2.33个降低为1.68个,次均处方费用中位数由160.00元降为58.19元。大兴某社区卫生服务中心"零差率"政策后糖尿病患者处方药品数量平均为3.65个,次均处方费用中位数为178.84元。通过建立计量经济学模型,药品"零差率"政策在其他因素不变的情况下使糖尿病患者单次处方的药品费用下降31.8%。结论北京市药品"零差率"政策使糖尿病患者的次均处方费用下降,但同时应注意配套政策收支两条线的真正落实才能使患者真正受益。Objective To study the influence of the policy ＂Without Added Profit＂ for basic pharmaceuticals on the medical costs of rural diabetic patients in Beijing basing on the econometric model.Methods Typical sampling two community health service（CHS） centers were chosen from Fangshan District and Daxing District respectively.A random sample of 540 prescriptions of diabetic patient was received.140 and 200 prescriptions were received from Fangshan District before and after implementation of the policy of ＂Without Added Profit＂ for basic pharmaceuticals respectively while only 200 prescriptions were received from Daxing District after the implementation of the policy.Results The average drug number of the prescription for the diabetic patients reduced from 2.33 to 1.68 after the implementation of the policy in a CHS center in Fangshan District while the number was 3.65 after the implementation of the policy in a CHS center in Daxing District.The median of prescription for the diabetic patients reduced from 160.00 yuan to 58.19 yuan after the implementation of the policy in a CHS center in Fangshan District while the median was 178.84 yuan after the implementation of the policy in a CHS center in Daxing District.The average prescription costs for the diabetic patients after the implementation of the policy of ＂Without Added Profit＂ for basic pharmaceuticals decreased by 31.8% basing on the other factors unchanged.Conclusion The policy of ＂Without Added Profit＂ for basic pharmaceuticals had reduced the average prescription costs for the diabetic patients in rural Beijing.However only should be truly implemented the supporting policy of ＂Separated Management of Income and Expenditure＂ the patients would be benefit from the policy of ＂Without Added Profit＂ for basic pharmaceuticals.

关 键 词：药品 零差率 社区卫生服务 农村 糖尿病 

分 类 号：R193[医药卫生—卫生事业管理]