中国杭州市实施国家基本药物政策和零差率政策后药品合理使用及可负担性分析。
An analysis on rational use and affordability of medicine after the implementation of National Essential Medicines Policy and Zero Mark-up Policy in Hangzhou, China.
机构信息
School of Public Health, Fudan University, Shanghai, China.
Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
出版信息
PLoS One. 2019 Mar 14;14(3):e0213638. doi: 10.1371/journal.pone.0213638. eCollection 2019.
BACKGROUND
The National Essential Medicine Policy and the Zero Mark-up Policy was introduced to improve the rational use and affordability of medicine. This study analyzed the changes of medicine use at different Health Care Institutions in Hangzhou city after the implementation of National Essential Medicine Policy and the Zero Mark-up Policy.
METHODS
Facility based survey was conducted in 17 Health Care Institutions and 16406 outpatient prescriptions in 2011 and 2013 were collected. Average number of medicines, average number of antibiotics and average expenditure per prescription were analyzed. Comparisons between 2011 and 2013, among different levels of Health Care Institutions and age groups were conducted.
RESULTS
The average number of medicines per prescription, use of antibiotics, intramuscular (IM) injections and intravenous (IV) injections decreased while the use of hormones increased. No significant change of the average medicine expenditure per prescription was observed. Disparities among different levels of Health Care Institutions and different age groups existed.
CONCLUSION
The problems of poly-pharmacy, overuse of antibiotics, intramuscular (IM) injections and intravenous (IV) injections and hormones still existed, however mitigated after the implementation of The National Essential Medicine Policy and the Zero Mark-up Policy.
背景
国家基本药物政策和零差率政策的实施旨在提高药品的合理使用和可负担性。本研究分析了国家基本药物政策和零差率政策实施后杭州市不同医疗机构的用药变化。
方法
在 2011 年和 2013 年，在 17 家医疗机构进行了基于设施的调查，共收集了 16406 张门诊处方。分析了每张处方的平均用药数量、抗生素使用数量、平均处方支出。比较了 2011 年和 2013 年、不同级别医疗机构和年龄组之间的差异。
结果
每张处方的平均用药数量、抗生素使用、肌内（IM）注射和静脉（IV）注射减少，而激素使用增加。每张处方的平均药物支出没有明显变化。不同级别医疗机构和不同年龄组之间存在差异。
结论
尽管国家基本药物政策和零差率政策的实施缓解了多药使用、抗生素过度使用、肌内（IM）注射和静脉（IV）注射以及激素使用等问题，但这些问题仍然存在。
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