Yao Dongning, Xi Xiaoyu, Huang Yuankai, Hu Hao, Hu Yuanjia, Wang Yitao, Yao Wenbing
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing City, Jiangsu Province, China.
PLoS One. 2017 Nov 30;12(11):e0188354. doi: 10.1371/journal.pone.0188354. eCollection 2017.
Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system.
The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China.
Public county hospitals in China.
A national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists.
The overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most respondents (93.5%) have a primary or medium professional title. The median age and work seniority of respondents are 31 and four years, respectively. Only 18.5% of respondents chose this occupation by personal consideration or willingness.
The main findings in this research include the overall low coverage of clinical pharmacy services, the low rate of clinical pharmacy service software, hardware, and personnel as well as a wide variance in educational training of pharmacists at county hospitals.
临床药学不仅是一门医学学科，也是一个精心构建的公共卫生保健系统，与教育、培训、资格认证、科研、管理和人力资源等子系统紧密相关。中国是一个发展中国家，对包括临床药学服务系统在内的公共卫生系统的改善有着巨大需求。
本研究旨在评估中国临床药学服务的基础设施和人员素质。
中国县级公立医院。
对县级医院的临床药师进行了一项全国性调查。采用分层抽样策略进行抽样。使用描述性和推断性统计方法对回复进行分析。主要结果指标包括临床药学服务的覆盖范围、临床药师的总体人员配备、临床药学服务的软件和硬件、临床药学服务的收费模式，以及临床药师的教育背景、专业培训获得情况、实践经验和入职途径。
临床药学服务在科室规模（中位数 = 18.25%）和患者规模（中位数 = 15.38%）上的总体覆盖范围均未达到政府要求的100%覆盖。在57.73%的样本医院中，人员配备不符合要求，且大型医院的临床药师团队规模较小。此外，23.4%的样本医院没有针对临床药师的管理规定，43.1%没有政府要求的合理用药软件。在收费方面，89.9%的样本医院对服务不收费。在教育方面，8.5%的受访者学历不合格，在学历合格的受访者中，37.31%专业不合格；43%的受访者缺乏政府要求的临床药师培训。大多数受访者（93.5%）具有初级或中级职称。受访者的年龄中位数和工作年限分别为31岁和4年。只有18.5%的受访者是出于个人考虑或意愿选择这个职业的。
本研究的主要发现包括临床药学服务总体覆盖范围低、临床药学服务软件、硬件和人员配备率低，以及县级医院药师教育培训差异大。
