台州市降压类基本药物全额保障政策对药品费用负担公平性影响的研究
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篇名: 台州市降压类基本药物全额保障政策对药品费用负担公平性影响的研究
TITLE: Study on the Effects of Full Coverage Policy for Essential Antihypertensive Medicines on the Equity of Medicine Expenditure Affordability in Taizhou City
摘要: 目的:为提高我国药品公平性,推进基本药物全额保障政策的实施提供参考。方法:以浙江省台州市4个地区降压类基本药物全额保障为例,提取基线年及政策实施后第1、2、3年的高血压患者的电子健康档案资料,以家庭药品灾难性支出衡量当地患者的药品费用负担,借助集中指数及其分解方法,分析基本药物全额保障政策对当地药品费用负担公平性及变化的影响。结果:随着免费服药人数占比升高,高、中、低收入组家庭药品灾难性支出发生率总体呈逐年降低趋势(分别由基线年的6.3%、12.0%、16.4%降低至政策实施第3年的4.7%、8.9%、12.4%),3组差距呈逐年缩小的趋势。基线年和政策实施第1、2、3年的集中指数为-0.198、-0.186、-0.181、-0.202,其中政策贡献率分别为0、-1.335%、-4.507%、1.936%,政策在逐年集中指数变化中的贡献率分别为20.8%、95.0%、57.6%。结论:实施基本药物全额保障政策有利于改善患者药品费用负担的公平性,其实施效果受政策落实推进和配套制度的影响,但全面促进药品公平性需要多方政策协同作用。
ABSTRACT: OBJECTIVE:To provide reference for improving the equity of medicine in China ,and to provide reference for promoting the full coverage policy for essential medicine. METHODS :Taking hypertension essential medicines full coverage policy in 4 areas of Taizhou in Zhejiang province as an example ,the electronic health records of patients in baseline year and the first , second and third years after the implementation of the full coverage policy of hypertension were collected. The catastrophic expenditure of family drugs was used to measure the medicine cost burden ,and the effects of policy on the equity and change of local medicine cost burden were analyz ed by means of concentration index and its decomposition method. RESULTS :With the increase of the proportion of patients taking free medicine ,the incidence of catastrophic expenditure on household medicines in the high,middle and low income group decreased year by year generally (decreasing from 6.3%,12.0%,16.4% of baseline year to 4.7%,8.9%,12.4% at the third year after the implementation of the policy );the gap among the three groups was in narrowed trendency. The concentration indexes of the baseline year and the first ,second,third year after the implementation of policy were -0.198,-0.186,-0.181,-0.202,the policy contribution rates of which were 0,-1.335%,-4.507% and 1.936%;and the policy contribution rates in the change of the yearly concentration index were 20.8%,95.0% and 57.6%. CONCLUSIONS :The implementation of the full coverage policy for essential medicines is conducive to improving the equity of the medicine expenditure burden. The effect is affected by the implementation of policies and supporting systems ,but the comprehensive promotion of the equity of medicine requires multi-policy synergy.
期刊: 2020年第31卷第09期
作者: 郭志刚,徐子悦,张翕,郑利光,管晓东,史录文
AUTHORS: GUO Zhigang ,XU Ziyue,ZHANG Xi,ZHENG Liguang ,GUAN Xiaodong ,SHI Luwen
关键字: 台州市;基本药物;全额保障政策;公平性;高血压;药品费用负担
KEYWORDS: Taizhou city ;Essential medicine ;Full coverage policy ;Equity;Hypertension;Medicine expenditure affordability
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