基层医疗机构高血压与糖尿病治疗基本药物配备与可获得情况分析

目的:了解基层医疗机构高血压与糖尿病治疗基本药物配备与可获得情况、影响因素及对高血压和糖尿病防治的影响。方法:通过stata 15.0分析2018年2 443家基层医疗机构的调查数据。结果:乡镇卫生院和社区卫生服务中心降压基本药物平均可获得率分别为37.88%和44.08%;降糖基本药物则为33.00%和47.21%。乡镇卫生院和社区卫生服务中心配备10～15种降压基本药物的机构占比均最高,分别为48.82%和55.06%。乡镇卫生院配备4～6种降糖药的机构占比较高,为41.96%;而社区卫生服务中心配备7～9种降糖药的机构占比最高,为31.09%。服务人口、卫生技术人员、执业(助理)医师数量及总诊疗人次、高血压或糖尿病诊疗人次均对降压、降糖基本药物配备率有影响(P0.05)。高血压和糖尿病治疗基本药物配备率对两病患者管理率有正向影响,但对管理效果的影响不确定。结论:基层医疗机构降压降糖基本药物配备率和可获得性不足,且城乡之间有差异。提高降压降糖药物配备率有助于改进患者管理率,但要改进管理的效果还需更多措施。

Analysis on the availability and allocation of essential drugs for hypertension and diabetes in primary health institutions

Objective: To carry out a deep investigation on the availability and allocation of essential drugs for hypertension and diabetes in primary health institutions, to analyze the influencing factors and their relationship with the management of hypertension and diabetic patients'' health. Methods: Data collected in 2018 from 2443 primary health institutions were analyzed by EXCEL, SPSS and Stata15.0. Results: The average availability rates of essential antihypertensive drugs in township hospitals and community health centers were 37.88% and 44.08%, while the rates of essential hypoglycemic (anti-diabetic) drugs were 33.00% and 47.21%, respectively. Township health institutions and community health centers which were equipped with 10~15 kinds of essential antihypertensive drugs, and the rates were 48.82%and 55.06%, which accounted for the highest proportion. Township hospitals which were given 4~6 kinds of essential hypoglycemic drugs had a rate of 41.96%, while community health centers with 7~9 kinds of essential anti-diabetic drugs had a rate of 31.09%, respectively. Service population, healthcare professionals, practicing/assistant doctors, diagnosis and treatment times, hypertension or diabetes mellitus diagnosis and treatment times all had a significant influence on the allocation rates of essential antihypertensive and anti-diabetic drugs in primary health institutions (P<0.05). Those respective allocation rates were positively related to the management rate of patients, but presented uncertainty to be related with the management effect. Conclusions: The allocation and availability rates of essential antihypertensive and anti-diabetic drugs in primary health institutions are not sufficient. However, there are differences between rural and urban areas. In order to improve health management of patients, the allocation rates of those essential drugs should be increased, and more strategies are needed to improve the patients'' health management effect.