中文摘要：

目的了解基本药物制度背景下山东省社区卫生服务中心门诊处方费用。方法于2012年8月—2013年1月,采用多阶段分层随机抽样的方法,在山东省抽取13家社区卫生服务中心,在该13家社区卫生服务中心中选取2009年（基本药物制度实施前）门诊处方180张、2012年（基本药物制度实施后）门诊处方200张。分析基本药物制度实施前后社区卫生服务中心的门诊处方费用变化情况,以及不同情况患者的处方费用变化情况。结果基本药物制度实施后,社区卫生服务中心的＂贵处方＂（费用〉100.0元）比例、中位门诊处方费用、＂大处方＂（药品种数〉5种）费用、非＂大处方＂费用、非抗生素处方费用、非激素类处方费用、注射剂处方费用、非注射剂处方费用、非中成药处方费用均低于实施前,差异有统计学意义（P〈0.05）;而抗生素处方费用、激素类处方费用、中成药处方费用与实施前比较,差异无统计学意义（P〉0.05）。基本药物制度实施后,男性、18～59岁及慢性病患者的门诊处方费用低于实施前,非慢性病患者的门诊处方费用高于实施前,差异有统计学意义（P〈0.05）;而女性、≤17岁、≥60岁患者的门诊处方费用与实施前比较,差异无统计学意义（P〉0.05）。结论基本药物制度实施后,社区卫生服务中心门诊处方费用有所降低,男性、18～59岁及慢性病患者的费用下降明显,抗生素、激素及中成药处方的费用降低不明显。应继续积极推进基本药物制度的实施,并进一步促进社区卫生服务中心的处方合理用药。

英文摘要：

Objective To investigate the prescription charge in community health service centers in Shandong Province under the national essential medicine system. Methods From August 2012 to January 2013, using multi - stage stratified random sampling method, we selected 13 community health service centers, and selected 180 prescriptions in 2009 （before the implementation of the national essential medicine system） and 200 prescriptions in 2012 （ after the implementation of the national essential medicine system） from the 13 centers. Changes of the prescription charge in the community health service centers after the implementation of the national essential medicine system, and the changes of the prescription charge of patients with different conditions were analyzed. Results After the implementation of the national essential medicine system, the proportion of ＂ expensive prescriptions＂ （charge 100. 0 yuan） in community health service centers, the medium prescription charge, the charges for ＂ big prescriptions＂ （categories of medicine 〉5 kinds） ,＂ non -big prescriptions＂ , non -antibiotic prescriptions, non- hormonal prescriptions, injection prescriptions, non -injection prescriptions and non -Chinese patent medicine prescriptions decreased significantly （ P 〈 0. 05 ） ; the charges for antibiotic prescriptions, hormonal injection prescriptions and Chinese patent medicine prescriptions were not significantly different from those betbre implementation （ P 〉 0. 05 ） . After the implementation of the national essential system, the prescription for male patients, patients aged 18 -59 and patients with chronic diseases had lower charge than that before implementation （P 〈 0. 05 ） ; the prescription charge for patients without chronic diseases was higher than that before implementation （ P 〈 0. 05 ） ; the prescription charge of female patients, patients aged ~〈 17 or /〉 60 were not significantiy different from those befbre implementation （ P 〉 0. 05 ） . Conclusion Alte