中文摘要：

目的：评价上海实施国家基本药物制度后患者的药品经济负担。方法：运用Excel2007进行数据录入和统计,分析上海市药品零售价格的变化,药品总费用、药品门急诊次均费用、出院患者次均药品费用的变化和城乡特定疾病药品经济负担的变化。结果：上海市药品加权零售价格下降了11.83%;社区卫生服务中心药品总费用下降了6.25%,门急诊次均药费下降了5.87%,出院患者次均药费下降了3.42%;高血压患者次均药品费用,城市地区由原来的100.60元降为88.32元,农村地区由原来的67.30元降为53.99元;急性上呼吸道感染患者次均药品费用,城市地区由原来的73.10元降为69.24元,农村地区由原来的70.47元降为42.86元。城市和农村地区分别有38.64%和34.21%的患者认为就诊费用降低。结论：国家基本药物制度实施后,药品费用有所下降,但患者感受不明显,且城乡患者经济负担差距较大;社区卫生服务中心存在一定程度的多做检查和开贵药的倾向,医师的诊疗行为仍有待规范。

英文摘要：

OBJECTIVE：To analyze the changes of drugs economic burden of patients after the implementation of national essential drug system in Shanghai.METHODS：Using Excel 2007 for data input and analysis,the changes of the retail prices of drugs,the total costs of drugs,the drugs expense of outpatient and emergency department each time and the average drugs expense of discharged patients each time were analyzed as well as the changes of drug economic burden of specific diseases both in urban and rural areas.RESULTS：The weighted retail prices of drugs had decreased by 11.83%;the total costs of drugs had decreased by 6.25% in community health care center,the average drugs expense of outpatient and emergency department each time had decreased by 5.87%,the average drugs expense of discharged patients each time had decreased by 3.42%;the average expense of patients with hypertension each time had decreased from 100.60 yuan to 88.32 yuan in urban areas,67.30 yuan to 53.99 yuan in rural areas;the average expense of patients with acute upper respiratory infection each time had decreased from 73.10 yuan to 69.24 yuan in urban areas,70.47 yuan to 42.86 yuan in rural areas.Results of survey showed 38.64% and 34.21% of the patients thought their medical expense had a reduction in urban areas in rural areas.CONCLUSION：After implementation of national essential drug system,drug cost decrease to some extent,while patients have no obvious feeling and great gap of economic burden exist between urban area and rural area;the physicians＇ behavior should be standard,for there is a tendency to over-prescribing drugs and over-expensive drugs in community health care center.