实施国家基本药物制度对上海市某社区卫生服务中心门诊用药的影响
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篇名: 实施国家基本药物制度对上海市某社区卫生服务中心门诊用药的影响
TITLE:
摘要: 目的:为推动社区卫生服务中心进一步实施国家基本药物制度、促进合理用药提供参考。方法:采集2009年9月2日-2014年11月25日上海市徐汇区长桥街道社区卫生服务中心门诊处方用药数据,对国家基本药物制度实施前、实施后和非基本药物增补后各阶段的用药品种、处方张数、用药金额、用药频度(DDDs)进行统计和分析。结果:各阶段基本药物均占据用药主导,用药金额和处方张数呈大幅增长趋势;基本药物中中成药和心血管系统用药使用金额和处方量合计占比均超50%,且呈现较高的环比增长率;用药金额和DDDs排序前10位的品种均为基本药物,其中多数为《上海市基层医疗卫生机构增补药物目录(2010版)》品种,且部分品种与《国家基本药物目录》(2012年版)重叠;心脑血管疾病用药品种占据主导地位;头孢替安、阿托伐他汀用药金额环比增长率最高,碳酸钙D3、厄贝沙坦氢氯噻嗪DDDs环比增长率最高。结论:基本药物目录覆盖了基层用药的常用品种,但其中的中成药和抗菌药物的规范性使用问题值得关注。应加强基本药物的合理使用,并适时调整基本药物目录,地方按需增补非基本药物,以真正满足患者的用药需求,优化医疗资源配置。
ABSTRACT: OBJECTIVE: To provide reference for promoting the further implementation of national essential medicine system and rational use of drugs in community health service center. METHODS: Outpatients’ information in Changqiao Street Community Health Service Center from Sept. 2, 2009 to Nov. 25, 2014 was collected to statistically analyze the drug variety, the number of prescriptions, the consumption sum and the DDDs before and after the implementation of essential medicine system and after the supplement of non essential medicines. RESULTS: Essential medicines occupied the main position of drug utilization in each stage, with substantial growth in respects of consumption sum and number of prescriptions; the sum of Chinese patent drugs and essential cardiovascular drugs occupied more than 50% of the total consumption sum and number of prescriptions, with higher growth rate; essential medicines occupied the top 10 in respects of consumption sum and DDDs, among which most were the drug varieties in “Shanghai supplement essential drugs in community health service center” (2010 Edition), with some overlap the varieties in “National Essential Medicine System” (2012 Edition); cardio-cerebrovascular drugs occupied the dominant position; the growth rates of cefotiam and atorvastatin took up the top 2 ranking in the list of consumption sum, while the growth rates of calcium carbonate D3 and irbesartan and hydrochlorothiazide took up the top 2 ranking in the list of DDDs. CONCLUSIONS: Essential medicine catalog covers the common drugs in the community health service center, in which the rational use of Chinese patent drugs and antibacterial deserves needs to be noticed. The clinical rational use of the essential medicines should be strengthened, the essential medicine catalog should be adjusted and non essential medicines should be supplied when necessary in order to truly meet the needs of patients and optimize the allocation of medical resources.
期刊: 2016年第27卷第18期
作者: 刘艳,朱福,张蓉蓉,毛士龙
AUTHORS: LIU Yan,ZHU Fu,ZHANG Rongrong,MAO Shilong
关键字: 国家基本药物制度;社区卫生服务中心;门诊用药;影响
KEYWORDS: National essential medicine system; Community health service center; Drug utilization of outpatients; Effect
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