河南省基层医疗卫生机构基本药物制度实施效果

目的：分析河南省基本药物制度实施效果，为完善相关政策提供建议。方法：从可获得性、可负担性和合理用药等方面选取关键指标，收集河南省3个城市6个区县基层医疗卫生机构的相关数据，进行改革前后的比较分析。结果：基本药物配备率和使用率逐年递增，可获得性提高，但有部分医务人员和患者认为不能满足治疗需求；基本药物采购价格和销售价格均下降，患者对改革后基本药物价格和费用的满意度较高，可负担性得到改善；处方合理用药问题得到有效缓解，社区卫生服务中心优于乡镇卫生院。结论：完善地方基本药物增补目录，采用综合评价的方式改良“双信封”评标机制，提高乡镇卫生院药品管理能力，并加强基本药物制度的培训和宣传．以满足医务人员和患者对基本药物的合理期望。

Effect on implementing essential medicine system at primary healthcare institutions in Henan Province

Objective： In this paper, we analyze the effects of implementing essential medicine system in Henan and provide suggestions for perfecting policy. Methods：We selected key indicators and collected data from pri- mary heahheare institutions in three cities and six districts or counties. We compared the availability, affordability, and rational use of essential medicine before and after the reforms. Results ： The delivery and utilization rate of essen- tial medicine increased year on year. Availability improved, but some medical staff thought availability did not meet the demand of treatment. The wholesale and retail prices of essential medicine were both fell. Staff and patients were satisfied with the reformed prices and affordability. The rational use of drugs was relieved, and community health cen- ters were better than health clinics in towns and townships. Conclusions： We suggest creating selection principles for local essential medicine lists as soon as possible. We also suggest replacing the double-envelope evaluation mode with a comprehensive evaluation method, improving drug management in health clinics in towns and townships, and im- proving education on essential medicine so that medical staffs and patients have realistic expectations.