基于成都市家庭药品使用和储备情况的药品可及性调查分析
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篇名: 基于成都市家庭药品使用和储备情况的药品可及性调查分析
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摘要: 目的:为进一步全面评价“新医改”实施后家庭药品可及性的改善情况提供参考。 方法:参考世界卫生组织《药品可及性及药品使用情况入户调查指南》设计调查问卷,在成都市2个市区、2个县城和2个乡镇共抽取180户家庭为样本,调查其药品使用和储备情况以及可及性现状,并就调查结果进行统计和分析。结果:共发放问卷180份,回收有效问卷179份,有效回收率为99.44%。在急性病用药方面,使用抗菌药物治疗急性病的比例受访的市区和县城家庭均超过50%,而乡镇家庭有超过60%患急性病时选择从公立医疗卫生机构购买药品;在慢性病用药方面,受访家庭中患有慢性病但未服药的比例较低(3.80%);在家庭储备药品方面,受访家庭中不储备药品的比例较低(13.41%)。在药品可及性方面,受访家庭认为公立医疗卫生机构位置便利以及排诊时间合理的比例均较高;“由于药品无法在当地药店或医疗卫生机构购买而导致患者没有按医嘱服用药物”的情况均未出现,而“认为所需要的药品在公立医疗卫生机构以及药店都能买到”的受访家庭比例均在95%以上;基本药物在3个层次家庭慢性病用药中占比均超过60%;能负担得起药品费用的受访家庭比例超过85%,而受访家庭每月用于治疗急性病和慢性病的药品支出占家庭当月总支出的比例均较低;受访家庭医保覆盖率达到99.44%,但能报销急性病、慢性病药品费用的比例较低(14.13%、12.66%)。结论:当前成都市家庭的药品可及性水平较高;国家基本药物制度实施对减轻慢性病家庭经济负担方面产生了积极影响。但在医保报销水平及急性病抗菌药物使用方面还存在不足,建议采取多种措施加以解决,如探索稳定有效的医保基金筹集渠道,适当提高补偿力度,提高医保报销水平,制定相应的抗菌药物监管制度,规范居民合理使用抗菌药物行为。
ABSTRACT: OBJECTIVE: To provide reference for further comprehensive evaluation of the improvement of the accessibility of family medicines after the implementation of the new health care reform. METHODS: Sampled as 180 households from 2 urban areas, 2 counties and 2 rural areas in Chengdu, a questionnaire survey was adopted based on the WHO’s manual for the Household Survey to Measure Access and Use of Medicines to investigate the situation of drug use, storage and accessibility, and the results were statistically analyzed. RESULTS: Totally 180 questionnaires were sent out, 179 were effectively received with effective recovery of 99.44%. In the terms of medicines taken for the acute illness, there were more than 60% rural households obtained drugs from the public health care facilities, while more than 60% counties households purchased drugs in public medical and health institutions; in the terms of medicines taken for the chronic illness, the proportion of households reporting a chronic illness who did not take any medicines was low (3.80%); in terms of medicines storage, the proportion of households without reserve drugs was low (13.41%). In terms of drug accessibility, the proportions of respondents who agreed that the location and opening hours of their public healthcare facility were convenient were high; there was no situation for “patients did not take prescribed drugs because medicines were not available at the healthcare facility and drug store”, while more than 95% respondents who agreed that drugs were available at their public health care facilities and drug stores; the essential medicines in the household use of chronic drugs in Chengdu accounted more than 60%; more than 85% can afford the drug costs, while the proportion of the monthly costs for acute illness and chronic illness in the total month costs was low; the health insurance coverage reached 90% in the survey households, but the proportions of households which could reimburse acute, chronic illness drug cost were lower (14.13% and 12.66%). CONCLUSIONS: At present, the level of drug accessibility in Chengdu is high; the implementation of National Essential Medicines System has a positive effect on reducing the economic burden of chronic disease family. But there are shortcomings in the Medicare reimbursement levels and antibiotics use, it is suggested to take effective measures to solve it, such as exploring the stable and effective medical insurance fund raising channels, improving the compensation level and the level of insurance reimbursement, formulate and implement the corresponding antibacterial drugs supervision system and regulate the rational use of antibiotics in residents.
期刊: 2016年第27卷第21期
作者: 俞建龙,胡海瑶,冯双,胡明,周乃彤
AUTHORS: YU Jianlong,HU Haiyao,FENG Shuang,HU Ming,ZHOU Naitong
关键字: 新医改;成都市;家庭;药品;使用;储备;可及性;调查分析
KEYWORDS: New medical reform; Chengdu; Household; Drugs; Use; Storage; Accessibility; Investigation and analysis
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