“新农合”后乡镇卫生院住院患者病种构成、用药情况调查分析

目的:了解"新农合"后农村乡镇卫生院住院患者病种构成和药物使用情况,促进临床合理用药。方法:采用抽样调查的方法,对10个乡镇卫生院320例住院患者"‘新农合’住院审核补助凭据"中的住院详细信息进行分类调查。结果:系统疾病排名前3位的是泌尿生殖系统疾病(27.19%)、循环系统疾病(25.31%)、消化系统疾病(15.31%)。人均住院费为988元,平均住院时间为12d,药费占总费用的64.31%。抗菌药物居首位,占用药总金额的39.12%;心脑血管系统用药占第2位(24.24%),以活血化瘀的中药注射液为主;输液及电解质类占第3位(14.13%)。抗菌药物使用率为94.38%,平均使用抗菌药物2.61种。基本药物使用率为69.69%,基本药物用药金额占总用药金额的76.78%。结论:乡镇卫生院以药物治疗为主,抗菌药物在用药金额消费结构中占很大比例,需进一步加强抗菌药物合理应用的管理。

Investigation and Analysis of Disease Specie Constitution,Medication Utilization of Inpatients in Township Health Centers after the Implementation of New Rural Co-operative Medical System

OBJECTIVE：To understand the drug use of inpatients in township health center after the implementation of New Rural Cooperative Medical System（NRCMS）and to provide reference for rational use of drugs.METHODS：The hospitalization information of 320 inpatients from 10 township health centers in ＂evidence of NRCMS hospitalization auditing allowance＂ was investigated and classified systematically by using sampling survey method.RESULTS：The top 3 systemic diseases were genitourinary system diseases（27.19%）,circulatory diseases（25.31%） and digestive system diseases（15.31%）.The cost of hospitalization was 988 yuan per capita for 12 days in hospital.The expense of medicine was 64.31% in total cost of hospitalization.And the cost of antibiotics was 39.12% in total drug expenses and took up the first place,followed by drugs for cardiovascular system（24.24%）,there were mainly TCM injection for activating blood and dissolving stasis;infusion and electrolyte type occupied the third place（14.13%）.The utilization ratio of antimicrobial drug was 94.38%,involving 2.61 kinds of antibiotics averagely.The utilization ratio of essential drugs was 69.69%.The cost of essential drugs accounted for 76.78% of total drug cost.CONCLUSION：In township health center,the treatment is mainly based on drugs,among which antimicrobial drug occupy a large proportion of drug cost.The management of rational use of antimicrobial drug needs to be further strengthened.