目的:分析基本药物制度的政策效应及存在的问题,提出相应的对策建议,为政策可持续发展提供参考。方法:依据新医改、基本药物制度的政策求和住院患者的政策效应感知进行定性定量分析。结果:在提高基本医疗服务基层可获得性、改善药物使用合理性方面政策效应明显,降低医药费用负担的效应有限;实施中存在患者就诊和住院向上一级医疗机构反流的倾向,基层医疗机构滥用输液治疗加重的问题。结论:通过提高基层医疗机构的服务能力,调整医疗保险报销机制,引导患者流向基层医疗机构,降低医药负担;加强医患沟通与合作,提高用药合理性。
Objective To analyze the policy effect and existing problems of essential medicine system, and to put forward the corresponding countermeasures for the sustainable development policy. Methods On the basis of policy requirements by New Health Care System Reform and essential medicine system, the policy effect perception of hospitalized patients was analyzed qualitatively and quantitatively. Results The policy effect of improving the basic medical service availability and the rationality of drug use were obviously, the policy effect of reducing the burden of medical expenses was not obviously. The problem of policy implementation was a tendency of flowing to higher medical institutions when patients diagnosed and hospitalized, and abuse infusion therapy in Grassroots medical institutions became worse. Conclusions By improving the basic medical service ability, adjusting the reimbursement mechanism of medical insurance, the patients were guided to the grass-roots medical institutions when they diagnosed and hospitalized to reduce the medical burden of patients in order to strengthen the doctor-patient communication and cooperation and improve the rationality of drug use.