基于北京市2家“三甲”医院调查结果探讨基本药物优先使用的可行性  

Exploration on the Feasibility of Priority Use of Essential Medicines Based on the Investigation Results in Two Third-level Grade-A Hospitals in Beijing

作　　者：刘治军[1] 谭玲[1] 余俊先[2] 胡欣[1] 

机构地区：[1]卫生部北京医院药学部,北京100730 [2]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国药房》2015年第18期2452-2455,共4页China Pharmacy

摘　　要：目的：为促进基本药物的优先使用提供参考。方法：调查和统计北京市2家综合性＂三甲＂医院2011-2013年度基本药物使用金额占比,同时检索基本药物政策和推广应用方面的文献,进行深入分析。结果：卫生部北京医院2011-2013年度门急诊基本药物使用金额占比分别为24.04%、23.10%和22.76%,住院患者基本药物使用金额占比分别为16.56%、14.52%和12.04%;取消＂药品加成＂的医改试点医院北京友谊医院3个年度门急诊基本药物使用金额占比分别为21.59%、19.85%和22.93%,住院患者基本药物使用金额占比分别为17.70%、17.62%和15.89%。从2家医改背景不同的综合性＂三甲＂医院来看,基本药物使用比例都未达到要求的25%~30%。结论：取消＂药品加成＂和调整基本药物目录种类及数量都未显著影响基本药物在综合性＂三甲＂医院的使用金额占比。建议通过医保总额预付制度、单病种付费制度或诊断相关分组预付制度和基本药物免费政策等,而不是通过行政命令推行基本药物的优先使用。OBJECTIVE：To provide reference for promoting the priority use of essential medicines. METHODS：The use amount ratio of essential medicines in 2 third-level grade-A hospitals in Beijing from 2011 to 2013 was statistically investigated.And the literatures related to policies of essential medicines and application were retrieved for in-depth analysis. RESULTS：The use amount ratios of essential medicines in the outpatient and emergency departments in Beijing Hospital of Ministry of Health from2011 to 2013 were respectively 24.04%,23.10% and 22.76%;and the use amount ratios of essential medicines of inpatients were respectively 16.56%,14.52% and 12.04%. The use amount ratios of essential medicines in the outpatient and emergency departments in Beijing Friendship Hospital（a pilot hospitals of cancelling drug addition medical reform）in the 3 years were respectively21.59%,19.85% and 22.93%;the use amount ratios of essential medicines of inpatients were respectively 17.70%,17.62% and15.89%. The use amount ratios of essential medicines did not meet 25%-30% of the requirements. CONCLUSIONS：Cancelling the drug addition and adjusting the types and quantity of essential medicine list had no obvious effects on the use amount ratios of general third-level grade-A hospitals. It is suggested to promote the priority use of essential medicines by systems of medical insurance total amount prepayment,single disease payment or diagnosis related groups-based prepayment and the free policy of essential medicines,rather than administrative order.

关 键 词：北京市 三级甲等医院 基本药物 优先使用 可行性 

分 类 号：R95[医药卫生—药学] R969.3