湖南省郴州市乡镇卫生院基层医生对国家基本药物制度试点效果满意度分析

目的了解湖南省郴州市乡镇卫生院基层医生对国家基本药物制度试点效果满意度,并分析其影响因素。方法采用分层整群随机抽样的方法,在郴州市随机抽取北湖区、苏仙区和桂阳县的9所乡镇卫生院作为调查现场。调查内容包括基层医生对国家基本药物制度的认知度、可及性、可获得性和试点效果满意度等。计算Cronbach’sα系数分析满意度问卷内部一致性,采用频率或构成比描述二分类资料,利用均数和标准差分析描述满意度值,统计推断方法包括95%可信区间,χ2检验,t检验或者方差分析。采用Logistic回归模型分析满意度的影响因素。所有统计分析应用SPSS16.0统计软件包,检验水准为α=0.05。结果 86.6%的基层医生了解国家基本药物制度,超过90%医生认为基本药物制度实行零差率销售会减少患者的药物经济负担,约60%基层医生对基本药物制度试点效果满意,但有68%的医生不满意科室药品收入,有69%医生认为现有基本药物不能满足临床常见疾病的诊治,多因素分析显示医学学历为影响满意度的主要因素。结论多数基层医生对国家基本药物制度试点效果满意,药品质量可以得到保障,国家基本药物制度能够减少患者的经济负担;大多数医生不满意科室收入和基本药物品种数量;中专医学学历的医生满意度较差。

Satisfaction on the Pilot Project of National Essential Drug System in Doctors at Township Hospitals of Chenzhou, Hunan Province

Objective To describe the satisfaction on the pilot effectiveness of national essential drug system in doctors at township hospitals of Chenzhou,Hunan Province,and to analyze the impact factors.Methods Stratified random cluster sampling was used,9 township hospitals were randomly selected from Beihu District,Suxian District and Guiyang County of Chenzhou.The questionnaire included awareness,accessibility,availability and satisfaction.The coefficient Cronbach’s α was calculated to analyze internal consistency of satisfaction questionnaire.The rate and proportion were used to describe binary data,mean and standard deviation for the score of satisfaction.Statistical inference included 95% confidence interval,Chi-square test,t test and ANOVA.Determinants of satisfaction were analyzed by multiple Logistic regression model.All statistical analyses were performed using the SPSS software,version 16.0,and test level was α = 0.05.Results Altogether 86.6% of the doctors knew the national essential drug system,more than 90% thought that zero selling of essential drug reduced the economic burden of the patients,and about 60% were satisfied with the pilot effectiveness of national essential drug system.However,68% were dissatisfied at the income from the drugs of department,and 69% thought that the kinds of the national essential drugs did not meet the requirements of the diseases treatment.The findings of multivariate analysis showed that the medical educational background was the main determinants of satisfaction.Conclusions Most of the doctors are satisfied with the pilot effectiveness of national essential drug system,and the qualities of drugs can be guaranteed.The national essential drug system can reduce the economic burden of the patients.Some doctors are dissatisfied with the income from the drugs of department and the kinds of the national essential drugs.Doctors graduated form secondary medical schools are more likely to dissatisfy with the essential drug system.