西部某省乡村基本药物制度实施情况研究

目的:研究基本药物制度在西部某省村级医疗机构的实施情况。方法:对西部某省乡村医生和管理者进行个人深入访谈,了解基本药物零差率补助、一般诊疗费补偿及基本药物考核机制的实施现状及其对乡村医生用药行为的影响。结果:该调查地区基本药物干预并未达到预期目标:乡村医生的用药行为没有明显变化;一般诊疗费制度未能实现合理补偿;乡村医生管理者对乡村医生的考核流于形式。结论与建议:该地区应充分考虑乡村医生的特殊性,保证干预的可行性、有效性和可持续性。

Status quo of National Essential Medicine System in village clinics of a province in western China

Objective:To study the status quo of National Essential Medicine System (NEMS) in village clinics of a province in western China. Methods: Individual in-depth interview was carried out with village doctors and their managers of a province in western China, to understand the subsidies of zero-markup rate, compensations for general medical fees, and status quo of NEMS assessment mechanism and its impacts on prescribing behavior of village doctors. Results: In the surveyed area, the intervention of NEMS has not achieved the desired objectives: the prescribing behavior of village doctors has not changed significantly; general medical fee system has failed to achieve reasonable compensations; and the assessment mechanism done by village doctor managers has been a mere formality. Conclusions and Suggestions: To ensure the feasibility, effectiveness and sustainability of the intervention, the area policymakers should take into full consideration the special nature of village doctors.