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湖北省住院患者药学服务需求及支付意愿现状调查及分析
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| 篇名： | 湖北省住院患者药学服务需求及支付意愿现状调查及分析 |
| TITLE： | Investigation and analysis of the current situation of pharmaceutical care demand and payment willingness of inpatients in Hubei Province |
| 摘要： | 目的 为推动药学服务目录的动态调整和医保分级支付等政策的制定提供实证依据。方法采用多中心横断面调查法，对湖北省12个地级市22家三级医疗机构的424位住院患者进行问卷调查，评估其药学服务需求、支付意愿及服务形式偏好，结合单因素与多元Logistic回归分析识别影响患者对药学服务支付意愿的关联因素和关键因素。结果仅39.86%的患者知晓药学服务或药师，89.62%的患者希望接受药学服务。16项药学服务中，受访患者对药物用法用量指导、用药注意事项告知，以及药物不良反应的识别、预防及处理的认可度较高，分别有96.70%、95.30%、94.12%表示非常赞同及赞同；对保险相关政策咨询、药物作用机制科普、中西药联用评估等服务的需求相对较低，分别有61.65%、68.47%、68.47%表示非常赞同及赞同。支付意愿的正向影响因素为家庭月收入＞5000元（OR＝1.742）、知晓药学服务或药师（OR＝3.620）、希望接受药学服务（OR＝4.686）（P＜0.05），而健康自评为“好”（OR＝0.390）则为负向影响因素（P＜0.05）。心脑血管疾病（54.48%）与降压药物（45.05%）为受访患者最希望覆盖的服务场景。85.14%的患者更倾向于“需要时服务”，单次服务时长以10min内为宜（84.43%），意愿支付金额以20元内为主（85.38%）。结论基于患者需求与支付行为特征，建议我国可考虑建立药学服务分级付费机制，并重点结合疾病与用药情况进行差异化设计；同时，应进一步明确驻科药师在用药重整、医嘱审核等环节的权责与服务标准，以全面提升药学服务的临床价值与政策可操作性。 |
| ABSTRACT： | OBJECTIVE To provide empirical basis for promoting the dynamic adjustment of the pharmaceutical care catalogue and the formulation of policies such as hierarchical payment of medical insurance. METHODS A multicenter cross- sectional survey method was adopted to conduct a questionnaire survey among 424 inpatients in 22 tertiary medical institutions in 12 prefecture-level cities of Hubei Province to evaluate their demand for pharmaceutical care， willingness to pay and preference for service forms. Combined with univariate and multivariate Logistic regression analysis， the influencing factors and key factors that affect patients’ willingness to pay for pharmaceutical care were identified. RESULTS Only 39.86% of the patients were aware of pharmaceutical care or pharmacists， and 89.62% of the patients hope to receive pharmaceutical care. Among the 16 types of pharmaceutical care， the patients surveyed had a relatively high recognition rate for guidance on drug usage and dosage， notification of medication precautions， and the identification， prevention and handling of adverse drug reactions. 96.70%， 95.30%， and 94.12% respectively expressed strong approval and approval. The demand for services such as insurance-related policy consultation， popular science on the mechanism of drug action， and assessment of the combined use of traditional Chinese and Western medicines was relatively low， with 61.65%， 68.47%， and 68.47% expressing strong approval and approval respectively. The positive influencing factors of willingness to pay were household monthly income ＞ 5 000 yuan （OR＝1.742）， awareness of pharmaceutical care or pharmacists （OR＝3.620）， and the desire to receive pharmaceutical care （OR＝4.686） （P＜0.05）， while self-rating health as “good” （OR＝0.390） was a negative influencing factor （P＜0.05）. Cardiovascular and cerebrovascular diseases （54.48%） and antihypertensive drugs （45.05%） were the service scenarios that the surveyed patients most hope to be covered. 85.14% of the patients preferred “service when xiaochnye@126.com needed”， with a single service duration of less than 10 minutes being appropriate （84.43%）， and the willingness to pay within 20 yuan being the main type （85.38%）. CONCLUSIONS Based on the characteristics of patients’ needs and payment behaviors， it is suggested that our country could consider establishing a hierarchical payment mechanism for pharmaceutical care， and focus on differentiated design in combination with diseases and medication situations. At the same time， the rights， responsibilities and service standards of resident pharmacists in the links such as medication reorganization and medical order review should be further clarified to comprehensively enhance the clinical value and policy operability of pharmaceutical care. |
| 期刊： | 2025年第36卷第18期 |
| 作者： | 叶小春；李程程；李璐璐；邓体瑛；刘杨从；李笛；张韶辉 |
| AUTHORS： | YE Xiaochun，LI Chengcheng，LI Lulu，DENG Tiying，LIU Yangcong，LI Di，ZHANG Shaohui |
| 关键字： | 药学服务需求；驻科药师；住院患者；支付意愿；分级服务；支付偏好；高血压 |
| KEYWORDS： | pharmaceutical care demand； resident pharmacist； inpatient； willingness to pay； graded service； payment |
| 阅读数： | 4 次 |
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