全国基层医疗卫生机构长期处方政策实施情况调查与分析  

Study and Analysis of the Implementation of the Long-term Prescription Policy in Primary Healthcare Institutions in China

作　　者：管雪帆 贾梦 王芳[1,2] GUAN Xuefan;JIA Meng;WANG Fang(Institute of Medical Information,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100020,China;不详)

机构地区：[1]中国医学科学院北京协和医学院医学信息研究所,北京100020 [2]中国医学科学院北京协和医学院卫生健康管理政策学院,北京100005

出　　处：《中国社会医学杂志》2025年第1期1-5,共5页Chinese Journal of Social Medicine

基　　金：中国医学科学院医学与健康科技创新工程项目(2021-I2 M-1-046);国家卫生健康委委托课题(门诊按人头付费与家庭医生签约服务结合的机制研究)。

摘　　要：目的了解全国基层医疗卫生机构长期处方政策的实施和认知情况,探讨存在的问题,为进一步优化长期处方政策提供对策建议。方法采用问卷调查法,于2022年11月-2023年1月在全国31个省的每个市随机抽取10家基层医疗卫生机构作为样本填写问卷,共纳入有效机构问卷3465份作为研究对象,运用描述性统计分析法对全国基层医疗卫生机构长期处方实施情况进行全面分析。结果调查机构中,91.4%已开始实施长期处方,其中开具的长期处方适用病种覆盖高血压和糖尿病的机构均达到99%以上;62.8%的机构认为长期处方降低门诊量,58.8%认为减少一般诊疗收入,约90%机构表示未配套建立相应激励补偿措施。结论目前长期处方已覆盖全国大部分地区,但实施中仍存在支撑政策不同步、管理机制不完善、激励机制不健全等诸多问题。未来各地亟需按照国家政策规范,完善长期处方实施各个环节,健全配套政策与激励机制,依托家庭医生签约服务进一步推进长期处方政策,做实基层医疗卫生机构慢性病管理服务。Objective To understand the implementation of the long-term prescription policy in primary healthcare institutions at the national level,and to explore existing problems,so as to provide policy suggestion for further optimization of the policy.Methods 10 primary care institutions in each city of 31 provinces were randomly selected as samples and a self-designed questionnaire was conducted among them from November 2022 to January 2023.A total of 3465 institutions were included as the study object,and descriptive statistical analysis was applied to analyze the implementation of the policy.Results Currently,91.4%of the 3465 primary healthcare institutions investigated had implemented the long-term prescription policy,and above 99%of them had prescriptions covered hypertension and diabetes.62.8%institutions believed that the implementation of the policy had decrease outpatient visits,58.8%thought the implementation had reduced registration incomes;about 90%indicated that no incentive measures were provided.Conclusion The policy has covered most areas of the country currently,but there are still many problems such as lacking supportive polices,unsound management mechanism and inadequate incentive measures.It is urgent to improve the implementation of the long-term prescription policy in accordance with the national policy,to optimize supporting policies and incentive mechanisms,to promote the policy with the help of family doctor contract services,and to substantiate chronic disease management services in primary healthcare institutions.

关 键 词：长期处方 慢性病管理 家庭医生 签约服务 

分 类 号：R197.621[医药卫生—卫生事业管理]