2015—2017年湖北省基层医疗机构6种慢性病常用基本药物的可及性分析

目的:评价湖北省基层医疗机构治疗常见慢性病基本药物的可及性,为完善基本药物政策、提高基层慢性病管理水平提供依据。方法:收集2015——2017年湖北省基本药物集中采购平台发布的治疗6种常见慢性病(糖尿病、高血压、胃溃疡、哮喘、类风湿性关节炎和癫痫)药物的采购数据,采用基本药物配备比评价可获得性,以最低日薪为基准评价可负担性,由此分析可及性并提出提高可获得性和可负担性的建议。结果:2015——2017年,湖北省基层医疗机构治疗常见慢性病的基本药物配备比为40.00%～71.43%,总体可获得性水平较低;可负担性逐年有小幅度改善(治疗期费用与最低日薪的比值由2015年的1.91降至2017年的1.79),但总体水平仍较低,21个药物中超过70%的药物治疗期费用与最低日薪的比值大于1。结论:湖北省基层医疗机构治疗常见慢性病的基本药物可及性水平较低,建议优化治疗慢性病的基本药物品种、加强分级诊疗制度建设、降低治疗慢性病的基本药物的价格、完善治疗慢性病的基本药物的补偿机制,以提高基层慢性病管理水平。

Analysis of the Accessibility of Common Essential Medicine for 6 Kinds of Chronic Disease in Primary Health Care Institutions in Hubei Province from 2015 to 2017

OBJECTIVE:To evaluate the accessibility of essential medicine for common chronic disease in primary health care institutions in Hubei province,and to provide evidence for improving essential medicine policy and strengthening the management level of chronic disease.METHODS:The purchase data of essential medicine for 6 kinds of common chronic disease(diabetes,hypertension,gastric ulcer,asthma,rheumatoid arthritis and epilepsy)were collected from centralized drug procurement platform of Hubei province from 2015 to 2017;essential medicin equipping rate was used to evaluate the availability,and minimum daily wage was used to evaluate the affordability.So that accessibility could be analyzed and suggestions for improving accessibility and affordability were put forward.RESULTS:From 2015 to 2017,the equipping rate of essential drugs varied from 40.00%to 71.43%,and the availability of those medicine for common chronic disease was at a low level.The affordability improved slightly(the ratio of medication cost to minimum daily wage was decreased from 1.91 to 1.79 from 2015 to 2017)but remained low,and the ratio of medication cost to minimum daily wage for more than 70%of 21 drugs was less than 1.CONCLUSIONS:Since the accessibility of essential medicine for common chronic disease was at a low level in Hubei province,it is suggested to optimize kinds of essential medicine for chronic disease,to promote the construction of hierarchical medical system,to reduce the price of essential medicine for chronic disease,and to improve the compensation mechanism of essential medicine for chronic disease to further strengthen the management of chronic disease in primary health care institutions.