發(fā)布時(shí)間：2018-12-21 09:05

【摘要】：目的了解基本藥物制度背景下山東省農(nóng)村衛(wèi)生服務(wù)機(jī)構(gòu)門診處方費(fèi)用。方法于2012年8月—2013年1月,采用多階段分層抽樣的方法,在山東省抽取鄉(xiāng)鎮(zhèn)衛(wèi)生院37家、村衛(wèi)生室81家。以納入機(jī)構(gòu)的2009年(基本藥物制度實(shí)施前)門診處方和2012年(基本藥物制度實(shí)施后)門診處方為一般資料,分析基本藥物制度實(shí)施前后鄉(xiāng)鎮(zhèn)衛(wèi)生院和村衛(wèi)生室的門診處方費(fèi)用變化情況,以及不同情況患者的處方費(fèi)用變化情況。結(jié)果共納入基本藥物制度實(shí)施前鄉(xiāng)鎮(zhèn)衛(wèi)生院門診處方1 293張,村衛(wèi)生室門診處方1 230張;基本藥物制度實(shí)施后鄉(xiāng)鎮(zhèn)衛(wèi)生院門診處方1 569張,村衛(wèi)生室門診處方1 861張�；舅幬镏贫葘�(shí)施后,鄉(xiāng)鎮(zhèn)衛(wèi)生院的中位門診處方費(fèi)用"大處方"(藥品種數(shù)5種)費(fèi)用抗生素處方費(fèi)用激素類處方費(fèi)用、非激素類處方費(fèi)用、注射劑處方費(fèi)用非中成藥處方費(fèi)用低于實(shí)施前,差異有統(tǒng)計(jì)學(xué)意義(P0.05);而"貴處方"(費(fèi)用100.0元)比例、非"大處方"費(fèi)用、非抗生素處方費(fèi)用、非注射劑處方費(fèi)用中成藥處方費(fèi)用與實(shí)施前比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)�；舅幬镏贫葘�(shí)施后,村衛(wèi)生室的"貴處方"比例、中位門診處方費(fèi)用"大處方"費(fèi)用非"大處方"費(fèi)用、抗生素處方費(fèi)用、非抗生素處方費(fèi)用激素類處方費(fèi)用、非激素類處方費(fèi)用、注射劑處方費(fèi)用非注射劑處方費(fèi)用中成藥處方費(fèi)用、非中成藥處方費(fèi)用均低于實(shí)施前,差異有統(tǒng)計(jì)學(xué)意義(P0.05)�；舅幬镏贫葘�(shí)施后,男性、女性、≤17歲、18~59歲、非慢性病鄉(xiāng)鎮(zhèn)衛(wèi)生院患者的門診處方費(fèi)用低于實(shí)施前,差異有統(tǒng)計(jì)學(xué)意義(P0.05);而≥60歲、患慢性病鄉(xiāng)鎮(zhèn)衛(wèi)生院患者的門診處方費(fèi)用與實(shí)施前比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。男性、女性、≤17歲、18~59歲、≥60歲、患慢性病、非慢性病村衛(wèi)生室患者的門診處方費(fèi)用均低于實(shí)施前,差異有統(tǒng)學(xué)意義(P0.05)。結(jié)論基本藥物制度實(shí)施后,山東省農(nóng)村醫(yī)療機(jī)構(gòu)的門診處方費(fèi)用有所降低,村衛(wèi)生室優(yōu)于鄉(xiāng)鎮(zhèn)衛(wèi)生院。應(yīng)繼續(xù)貫徹落實(shí)基本藥物制度,充分發(fā)揮政策效應(yīng),同時(shí)加強(qiáng)對老年和慢性病患者處方的監(jiān)管力度。
[Abstract]:Objective to understand the outpatient prescription cost of rural health service institutions in Shandong province under the background of essential drugs system. Methods from August 2012 to January 2013, 37 township hospitals and 81 village clinics were selected from Shandong province by multi-stage stratified sampling. Taking into account institutional outpatient prescriptions for 2009 (before the implementation of the essential drugs system) and 2012 (after the implementation of the essential drugs system) as general information, To analyze the change of outpatient prescription cost of township health center and village health center before and after the implementation of essential drug system, and the change of prescription cost of patients with different conditions. Results there were 1 293 outpatient prescriptions in township hospitals and 1 230 prescriptions in village clinics before the implementation of the essential drug system, and 1 569 outpatient prescriptions in township hospitals and 1 861 prescriptions in village clinics after the implementation of the essential drug system. After the implementation of the essential drugs system, the median outpatient prescription cost of township health centers? "Big prescription" (5 kinds of drugs)? Antibiotic prescriptions? Hormone prescription fee, non-hormone prescription fee, injection prescription fee? The prescription cost of non-Chinese patent medicine was lower than that before implementation, the difference was statistically significant (P0.05); while the proportion of "expensive prescription" (100.0 yuan), non-" big prescription "fee, non-antibiotic prescription fee, non-injection prescription cost? There was no significant difference between the prescription cost of Chinese patent medicine and that before implementation (P0.05). After the implementation of the essential drugs system, the proportion of "expensive prescriptions" in village clinics, the median outpatient prescription cost, "big prescription" cost? No "big prescription" fee, antibiotic prescription fee, non-antibiotic prescription fee? Hormone prescription fee, non-hormone prescription fee, injection prescription fee? Non-Injection prescription fee? The prescription cost of Chinese patent medicine and non-Chinese patent medicine were lower than that before implementation, the difference was statistically significant (P0.05). After the implementation of the essential drug system, male, female, 鈮，

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