台州市降压药类基本药物全额保障政策的经济性评价
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篇名: 台州市降压药类基本药物全额保障政策的经济性评价
TITLE:
摘要: 目的:探讨降压类基本药物全额保障政策对浙江省台州市高血压患者经济负担的影响,为该政策的进一步实施和推广提供参考。方法:查询台州市各区县卫生部门统计数据,提取各区县基本药物全额保障政策实施前1年及实施后3年间高血压患者的电子健康档案数据,将一直坚持服用免费药品的患者纳入政策组、从未服用免费药品的患者纳入对照组,使用倾向性得分匹配法将政策组与对照组患者进行1 ∶ 1匹配,计算基本药物全额保障政策实施前后患者的人均药品费用和人均住院费用,并计算该政策的投入-产出比。结果:政策实施后的3年间分别为患者节约药品费用91.3、272.0、464.1元,第1、2年分别使患者住院费用增加65.6、46.2元,第3年为患者节约住院费用352.8元;3年间政策的累计人均投入分别为50.0、147.2、278.5元,投入-产出比分别为0.51、1.28、2.25。结论:台州市的降压类基本药物全额保障政策具有一定的经济性,但对疾病治疗效果的影响仍有待进一步研究。为保障政策稳定运行、凸显政策效果,需要政府部门长时间的持续投入,并完善配套措施,以使政策取得更大收益。
ABSTRACT: OBJECTIVE: To investigate the effects of full coverage policy for essential hypertension medicines on economic burden of hypertensive patients in Taizhou of Zhejiang Province, and to further provide reference for the practice and promotion of the policy for essential medicines. METHODS: By querying electronic health records database of hypertension patients and statistics of health bureaus in different districts and counties of Taizhou city, the data of electronic health records of hypertension patients were extracted 1 year before and during 3 years after the implementation of full coverage policy for essential medicines in all districts and counties. The patients who had consistently taken free medicines were included in the policy group; the patients who had never taken free medicines were included in the control group. The policy group and control group were matched 1 ∶ 1 by propensity score matching method. Per capita drug cost and per capita hospitalization cost of patients before and after the implementation of full coverage policy for essential medicines were calculated. The input-output ratios of the policy were calculated. RESULTS: During the 3 years after the implementation of the policy, each patient saved 91.3, 272.0 and 464.1 yuan respectively. The hospitalization cost for each patient increased by 65.6 and 46.2 yuan in the first and second year, and decreased by 352.8 yuan in the third year, respectively. A three-year per capita input of policy was 50.0, 147.2 and 278.5 yuan, with input-output ratio of 0.51, 1.28 and 2.25. CONCLUSIONS: The full coverage policy for essential hypertension medicines in Taizhou city demonstrates economic efficiency to some extent, but researches about the impact of policy on disease treatment needed to be conducted. It is necessary for the government departments to invest continuously for a long time and improve the supporting measures so as to make the policy more profitable.
期刊: 2019年第30卷第12期
作者: 阳明春,周簪荣,郭志刚,管晓东,史录文
AUTHORS: YANG Mingchun,ZHOU Zanrong,GUO Zhigang,GUAN Xiaodong,SHI Luwen
关键字: 高血压;基本药物;全额保障政策;经济性
KEYWORDS: Hypertension; Essential medicines; Full coverage policy; Economics
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