王云;宋沈超;
WANG Yun;SONG Shenchao;Department of Preventive Medicine,School of Public Health,Guiyang Medical College;

• 1:贵阳医学院公共卫生学院预防医学教研室

摘要(Abstract)：

目的:探讨基本药物制度的实施对贵州省基层医疗机构用药行为的影响。方法:从贵州省实施国家基本药物制度试点县(区、市)中随机抽取1 5个样本试点县(区、市)全部220家政府办基层医疗机构,对实施基本药物制度前(2009年)后(2010年)的门诊处方进行抽样调查,比较单张处方用药数量、抗生素比例、激素比例、注射剂比例、国家基本药物种数和处方金额的变化。结果:2010年单张处方药品品种数、单张处方联合用药5种以上处方比例低于2009年,差异有统计学意义(P<0.05);单张处方国家基本药物数高于2009年,差异有统计学意义(P<0.05);抗菌药物处方比例、抗菌药物三联及以上处方比例及平均每张处方抗菌药物数低于2009年,差异有统计学意义(P<0.05);单种抗菌药物处方比例高于2009年,差异有统计学意义(P<0.05);抗菌药物二联用处方比例、使用激素和注射剂的处方比例、单张处方金额无明显变化。结论:基本药物制度实施使贵州省基层医疗机构用药行为发生了一定的改变,基本药物使用有所增加,滥用抗生素的行为有所减少,但单张处方金额下降不明显。
Objective: To explore the effect of implementation of national essential drugs system on drug taking behavior of grassroots medical institutions. Methods: A total of 220 grass-roots medical institutions run by government were randomly selected from 15 samples of pilot county( city,district) of national essential drugs system in Guizhou province,and the outpatient prescription sampling survey was conducted before implementation( 2009) and after implementation( 2010),which involved comparison of the number of drugs in a single prescription,the proportion of antibiotics,the proportion of hormone,the proportion of injection,the variety of national essential drugs and the amount of prescription. Results: The number of drug varieties in a single prescription of 2010 and the number of prescription of more than 5 drug combinations in a single prescription of 2010 were lower than those of2009,which showed statistical differences( P < 0. 05). The number of national essential drugs in a single prescription of 2010 was significantly higher than that of 2009( P < 0. 05). The proportion of antibiotics prescription,the proportion of antibiotics prescription of more than 3 drug combinations and the average number of antibiotics in a single prescription of 2010 were significantly lower than those of2009( P < 0. 05). The proportion of single antibiotics prescription of 2010 was significantly higher than that of 2009( P < 0. 05). There was no significant difference in the proportion of antibiotics prescription of 2 drug combinations,the proportion of hormone and injection prescription and the amount of prescription between 2010 and 2009. Conclusion: The implementation of national essential drugs system brings in some changes in drug taking behavior of grassroots medical institutions,including increased use of national essential drugs and decreased abuse of antibiotics. But the amount of single prescription is not obviously decreased.

关键词(KeyWords)： 基本药物制度;基层医疗机构;处方结构;处方,药物;费用,药物
national essential drugs system;grassroots medical institutions;structure of prescription;prescription,drugs;expenses,drugs

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 王云;宋沈超;
WANG Yun;SONG Shenchao;Department of Preventive Medicine,School of Public Health,Guiyang Medical College;

DOI: 10.19367/j.cnki.1000-2707.2015.03.014

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