新医改背景下我国城镇地区医疗机构的药品配备及使用情况分析  

Allocation and utilization of medicines in hospitals in urban China during the new health care reform

作　　者：茅雯辉[1] 黄韻宇[1] 朱碧帆 陈文[1] 

机构地区：[1]复旦大学公共卫生学院卫生部卫生技术评估重点实验室健康风险预警治理协同创新中心,上海200032

出　　处：《中国卫生资源》2015年第4期244-247,共4页Chinese Health Resources

基　　金：世界卫生组织卫生政策与系统研究联盟(Alliance for Health Policy and System Research)资助(ATM2012-01-CHINA)

摘　　要：目的 :从不同级别医疗机构出发,旨在分析新医改下我国城镇地区医疗机构的药品配备和使用情况。方法 :采用结构化的医疗机构调查表,在杭州市和宝鸡市分别调查了20家不同级别医疗机构,收集其基本情况、药品配备种类、药品收入等信息。结果 :整体而言,两市的医疗资源分布略有差异,杭州市医疗机构配备的药品种类数远高于宝鸡。2009—2013年间,杭州市基层医疗机构总体配备的药品种类数、基本药物配备种类数和抗生素种类都呈下降趋势;除抗生素外,二级和三级医院的配备药品总数、基本医疗保险目录内药品总数略有上升。杭州市医疗机构药品费用占机构总收入的比例高于宝鸡市,调查年份内不同级别医疗机构超过一半以上的收入来源于药品收入。此外,虽然基层医疗机构药品收入占比高于三级和二级医院,但可以观察到该指标呈现较为明显的下降趋势。宝鸡市不同级别医疗机构除抗生素外,药品配备总数、目录内药品总数整体呈现上升趋势。结论 :国家基本药物制度和基层医疗机构改革对城镇地区基层医疗机构的药品配备起到了决定性作用,药品收入的增长也得到了控制。但如何在不影响医疗服务质量的基础上,改善二级和三级医疗机构的合理用药,降低药品费用占医疗机构总收入的比例,仍然是需要研究的问题。Objective ：To analyze the allocation and utilization of medicines in hospitals in urban area during the new health reform from the perspective of health facilities. Methods ：A structured facility survey was used in Hangzhou and Baoji cities. Twenty health facilities of different levels were included in each city and their general information and operational information including the number of medicines allocated and medicine revenue was collected. Results ：The distribution of health resources generally varied between the two cities. Health facilities in Hangzhou allocated much more kinds of medicines than that in Baoji. However,the total number of medicines,number of essential medicines and number of antibiotics in primary health centers decreased during 2009-2013 in Hangzhou while the total number of medicines and total number of medicines on the basic health insurance list increased in secondary and tertiary hospitals. The proportion of medicine revenue relative to total revenue was higher in Hangzhou than that in Baoji,which was over 50% for different levels of hospitals. Moreover,this proportion was higher in primary health centers than that in secondary and tertiary hospitals,but a significant decreasing trend was also observed. Except for antibiotics,the total number of medicines and number of medicines on the basic health insurance list was increasing in Baoji. Conclusion ：The positive effect on the allocation of medicines in the primary health facilities because of the implementation of the National Essential Medicines Policy and the reform of primary health facilities has been observed and the growth rate of the medicine revenue was under control. However,improving the rational use of medicines and reducing the medicine revenue in secondary and tertiary hospitals without losing quality remained an issue to be studied.

关 键 词：药品配备 药品收入 医疗机构调查 

分 类 号：R197.3[医药卫生—卫生事业管理] R197.61[医药卫生—公共卫生与预防医学]