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Augusto Afonso Guerra Francisco de Assis Acúrcio Carlos Alberto Pereira Gomes Maria Miralles Sábado Nicolau Girardi Gustavo Azeredo Furquim Werneck Cristiana Leite Carvalho 《Pan American journal of public health》2004,15(3):168-175
OBJECTIVE: To investigate the availability of essential drugs in municipalities with a human development index < 0.699. METHODS: We surveyed 69 institutions, including municipal pharmacies, public clinics, private and philanthropic health units, and commercial pharmacies, in 19 municipalities of the state of Minas Gerais, Brazil. The municipalities were chosen according to the following selection criteria: (1) a human development index (HDI) < 0.699 (the HDI for the entire state of Minas Gerais in 1991) in the microregion where the municipality was located; (2) the municipality had to be the seat of government for the microregion where it was located; (3) there had to be at least two eligible institutions (belonging to the public, private, or philanthropic sectors) in full functioning in the municipality during the survey period. Health professionals who were directly responsible for stock control and drug dispensation at the institutions surveyed were interviewed. Institutional documents and records were also reviewed. A list of 21 tracer essential drugs, which were selected among the drugs most widely employed in the State of Minas Gerais' Basic Pharmacy Program, was used to measure availability. The availability of each tracer drug was calculated at the time of the site visit and for the 12-month period immediately before the survey. In addition, the availability of tracer drugs was calculated for each type of institution surveyed. RESULTS: The availability of essential drugs in municipal pharmacies was 52.0%; in public health clinics, 46.9%; and in philanthropic and private health units, 41.0% and 38.1%, respectively. In commercial pharmacies, the availability of essential drugs reached 81.2%. CONCLUSION: The availability of essential drugs in public facilities is low and varies widely, with the result that persons who need such drugs the most are often those who lack access to them. Private pharmacies are the main source of essential drugs. The results of this study point to the need to seek increased awareness and implementation of the concept of essential drugs throughout the country. 相似文献
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目的 :分析上海市社区卫生服务中心基本药物目录外的实际用药需求。方法 :通过分析上海市医疗机构药品集中招标采购数据库,针对社区卫生服务中心的工作人员和就诊患者开展问卷调查,从3个角度定量分析基本药物目录外用药需求。结果 :基本药物目录外药品通用采购种类数占社区卫生服务中心药品通用名数的比例较高(66.6%),但采购金额所占比例小(4.4%);社区卫生服务中心工作人员对基本药物目录外药品的需求频次和紧缺程度上的反映略有差异;当社区患者配不到所需药品时,64%的被调查者会前往二、三级医院配药,12%的选择去药店购买,22%的选择替代药品,2%的选择自行停药。结论 :社区基本药物目录之外的药品使用需求是普遍的,但集中度极低,多属于"个性需求"。 相似文献
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目的:了解浙江省基层医疗卫生机构门诊患者对基本药物的认知和使用情况及存在的主要问题。方法:按经济发展水平选取3县(市、区),对到社区卫生服务机构或乡镇卫生院就诊的患者进行现场问卷调查。结果:有32.9%的人认为基本药物的药效低于非基本药物;37.8%的人认为基本药物就是廉价药;62.3%的调查居民表示,基本药物制度实施后会因为在乡镇卫生院或社区卫生服务中心配不到所需的药品而再去上级医院就诊。结论:居民对基本药物认知存在偏见,应加强对患者的基本药物宣传普及工作;基本药物品种不足导致患者流失制约基层医疗机构发展。 相似文献
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目的:以安徽省为例,了解基层医疗卫生机构的药品供应现状及药品短缺因素。方法:以安徽省基层医疗卫生机构为主要调查对象,通过分层随机抽样在皖北、皖中、皖南三个地区共抽取106家基层医疗卫生机构;并同时以方便抽样的方式抽取54家药品生产企业和62家药品经营企业;发放问卷了解基层医疗卫生机构的药品供应现状及造成药品短缺的主要原因和解决方法。结果:样本地区仍有13%的基层医疗卫生机构存在药品供应严重不足的现象;各个单位的药品配送率存在较大差异,有19%的基层医疗卫生机构药品配送率在70%以下;调查范围内的全部基层医疗卫生机构存在或者经历过药品短缺。导致药品短缺的主要原因有药品需求不稳定(19.20%)、药品有新的且利润较高替代品(15.94%)等;药品短缺的解决措施包括完善国家基本药物目录(12.78%),适当提高疗效确切、价格低廉品种价格(12.03%)等。结论:基层医疗卫生机构存在药品短缺现象,原因较为复杂;政府应继续推行相关政策,全面改善基层医疗卫生机构药品供应现状,防范药品短缺。 相似文献
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目的:了解浙江省基层医疗机构基本药物使用的相关情况及存在的主要问题。方法:按经济发展水平选取3个县(市、区),对社区卫生服务机构或乡镇卫生院医生开展现场问卷调查。结果:有65.1%的医生认为基本药物数量可以满足临床用药需求;认为基本药物制度对其医疗行为和用药习惯有影响的医生比例分别占71.9%和81.4%,基本药物实施后,认为向上级医院转诊患者人数增加和收入减少的比例分别占75.6%和68.5%。结论:浙江省基本药物数量基本可以满足临床用药需求,但仍存在不少问题。医生医疗用药行为改变,患者转向上级医疗机构;医生收入减少,工作积极性下降。 相似文献
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上海市基层医疗机构中实施基本药物“307+X”配备模式的可行性分析 总被引:1,自引:0,他引:1
利用2009年上海市医疗机构药品集中招标采购数据库,分析上海市基层医疗机构的实际用药现状,为上海市制定基层医疗机构基本药物的最终配备方案提供参考,以判断基本药物“307+X”配备模式在上海市基层医疗机构中实施的可行性。综合分析,“307+X”模式在上海实施具有可行性,但需要做好防止加重社区“配药难”现象的有效措施,做实收支两条线管理和遴选“X”时需要考虑国家基本药物目录本身的不足。 相似文献
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以成都市武侯区城乡居民基本医疗保障政策为例,分析了造成社区卫生服务门诊统筹政策偏差的原因。主要包括门诊报销比例过低、区域人口结构特殊、定点医疗机构单一、基本药物目录狭窄、政策宣传迟滞效应等。因此,未来的政策调整应该提高门诊报销比例,调整基本药物目录,加强政策宣传,完善相应的配套政策。 相似文献
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目的了解北京市丰台区城市居民合理用药知识现状,为今后开展相关健康教育和健康促进工作提供科学的参考依据。方法按照分层整群随机抽样原则,抽取方庄和大红门街道各4个居委会18~60岁居民414人进行问卷调查。结果女性的抗生素概念知晓率(93.3%)高于男性(81.9%),男性的处方药概念的知晓率(82.4%)高于女性(73.8%);18~29岁居民的处方药概念和鉴别假冒伪劣药品的关键方法知晓率最高,分别为84.0%和77.0%,50~60岁居民在这两方面的知晓率最低,分别为69.8%和59.5%。结论大部分居民合理用药认知率较高,但仍有少部分居民对基本药物知识知晓率低,且生活中存在不合理用药问题,应该针对不同性别、年龄的居民开展有针对性的健康教育和健康促进工作。 相似文献
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目的:了解上海市农村社区卫生服务站“提供基本药物”的现状,研讨其新时期提供基本药物问题。方法:采取分层抽样,对90个站2005年所提供的基本药物作回顾性调查研究。结果:90站中,提供基本药物最少的68种;最多204种;平均129种;社区卫生服务站平均药物种类95%可信区间为122~136种。按药理作用归类,共涉及20大类354种药物。提供品种数量前6类药物依次为:中成药;抗微生物药;心血管系统药;消化系统药;解热镇痛药;呼吸系统药。分别占总量的14.7%;11.6%;10.7%;10.1%;8.5%;7.0%。结论:解决农民基本医疗和公共卫生服务,应制定和完善社区卫生服务站(村卫生室)基本药物目录,在制定和实施基本药物目录过程中应考虑对其进行动态管理。 相似文献
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目的:了解上海市郊区社区卫生服务站(村卫生室)药品管理的现状,分析存在的问题,为制定《上海市农村社区卫生服务站基本药物目录》提供依据。方法:采用分层随机抽样的方法,进行问卷调查。结果:调查的72个社区卫生服务站(村卫生室)在药品管理中药品管理部门和药品采购部门的不统一、部分单位药品没有做到日清月结等;在药品使用过程中药物品种配备范围太大、部分村卫生室没有配备中成药等;在用药过程中,部分乡村医生对选择首选药品等存在错误认识。结论要统一药品管理部门和药品采购渠道,加强社区卫生服务站(村卫生室)药品的日常管理,制定上海市农村社区卫生服务站基本药物目录,提高乡村医生药品管理和使用药品的水平。 相似文献
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Benitez AJ 《Santé publique (Vandoeuvre-lès-Nancy, France)》1998,10(4):401-412
A survey was carried out by random sample among institutions that had benefited from the programme of humanitarian assistance during the period of economic embargo imposed in Haiti. The objective of this survey was to determine the effect that the distribution of medicines during this period had on the reactivation of the programme for essential drugs. Of the 51 health institutions selected, 45 provided satisfactory information. The results show that 42 institutions received medicines from the humanitarian aid programme. Six months after the end of the programme for humanitarian assistance, 39 of these institutions were using essential drugs in dispensaries and in health centres without beds. Essential drugs predominated over special medicines. These institutions continued to stock up at the PROMESS centre for essential drugs. This institution, initially created for the programme for humanitarian assistance, continued to function in October, 1994, a year after the end of the programme, and became the object of the adaptation of long-term support for programmes of the national health plan. The study also showed that the recovery of costs of medicines is a current practice within 44 of the 45 institutions surveyed, no matter whether their status is public, private, or mixed, thus emphasising the availability of the community for participating in financing health services. These results show that the humanitarian assistance programme, through the distribution of medicines and independently of its specific objectives, reinforced the programme for essential drugs. This is an indication that humanitarian assistance programmes may not only carry out their objectives, which are often limited and short-term, but may also produce lasting results that favour the reinforcement of development structures. 相似文献
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基本药物制度实施成效与问题——基于中西部四省16家基层医疗卫生机构的监测数据 总被引:1,自引:1,他引:0
目的:分析基本药物制度实施的成效与问题。方法:设计监测表格,在我国中西部选取重庆、四川、湖南和河南四个省份,每个省份抽取4家基层医疗卫生机构,进行数据填报和分析。结果:基本药物制度实施后,财政投入占总收入的比例增加,药品收入占总收入的比例下降,平均门急诊次均医疗费用和药品费用下降。结论:实施基本药物制度后,一定程度上缓解了人民群众“看病贵、看病难”的问题,但存在国家基本药物目录品种数目不能满足基层需要、老百姓并未切实感到实惠、基本药物配套政策不健全的问题。 相似文献
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Fasehun F 《Bulletin of the World Health Organization》1999,77(3):211-216
The concept proposed by WHO of an essential drugs list that should comprise drugs corresponding to the health needs of the majority of the people has been embraced by countries, which have adapted it to their needs. In this study, the essential antibacterial drug lists of 16 countries chosen from the six WHO regions are reviewed. Most of these countries include 73% of WHO-recommended essential antibacterials on their lists. However, most are lacking reserve antibacterials, and even some main list antibacterials, which are essential when empirical therapy fails in cases of bacterial resistance. Many factors that may be responsible for the lack of selection of these drugs, not least cost considerations, are discussed. 相似文献
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目的:了解上海市郊区社区卫生服务站(村卫生室)就诊疾病情况,为制定上海郊区社区卫生服务站(村卫生室)基本药物目录提供依据。方法:根据上海市地域及社会经济状况分组,对上海市郊区8个区(县)的72个农村社区卫生服务站(村卫生室)就诊疾病情况进行调查,分析各类疾病就诊频次构成比。结果:呼吸系统疾病占47.29%;循环系统疾病占21.23%;消化系统疾病占12.23%;3个系统的疾病占农村社区卫生服务站门诊就诊频次的80.59%。结论:上海郊区社区卫生服务站(村卫生室)就诊主要集中在呼吸系统、循环系统、消化系统三大系统的疾病上。该结论对农村社区卫生服务站(村卫生室)基本药物目录制定、药物储备方面具有指导意义;同时对加强3个系统的疾病预防、乡医培训及提高上海郊区农民的健康水平也具有积极作用。 相似文献
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目的评估居民家庭合理用药健康教育干预效果,为政府公共卫生决策提供依据。方法在浙江省3个县区12个社区/村所有18~60岁的居民开展合理用药健康教育干预。采用问卷调查的方法评估干预效果。结果干预组居民药物相关知识知晓率为66.00%,错误用药观念的识别率为55.38%,正确储存药品率、定期检查家中药品率和正确处理过期药品率分别为8.03%、18.62%和34.83%,药物不良反应正确处理率为35.15%。与干预前相比,干预组居民的药物相关知识知晓率与错误用药行为识别率和药品不良反应正确处理率有显著提高,但不合理用药行为改善不明显。结论合理用药健康教育干预显著提升了居民的知识水平,今后要继续加强健康教育干预,使居民形成合理用药的健康行为。 相似文献