山东省农村贫困高血压患者药费补偿政策的评价研究

目的评价山东省农村贫困高血压患者免费药物补偿政策的实施效果。方法通过倾向性得分匹配方法平衡干预组和对照组之间的差异,对结局变量进行比较,评价干预效果。方法将高血压患者按是否接受补偿分成干预组和对照组,利用倾向得分匹配方法进行配对后分析比较。结果干预组只有1例患者未服用降压药物,而对照组有12例患者未服用任何降压药物,占13.5%。干预组高血压患者总能坚持规律服药的患者比例高于对照组。干预组高血压患者自付费用的中位数为20元,比对照组(240.5元)低。干预组高血压患者的血压水平和控制率与对照组持平,没有统计学差异。结论干预组高血压患者的规律服药情况较好,说明免费药物补偿政策在一定程度上缓解了患者因经济困难导致的服药依从性差问题。免费药物政策有助于减轻高血压患者的经济负担。干预措施在控制血压方面没有明显效果,补偿方案在实施、管理中存在诸多问题。

Evaluation of the Free Medicine Policy for Poor Patients with hypertension in Rural Areas of Shandong Province

OBJECTIVE Evaluate the impact of the free medicine policy for poor patients with hypertension in rural areas in Shandong Province. METHODS Compare the outcome variables between the treatment and the control after balancing the difference by propensity score matching. RESULTS Only one patient who accepted the intervention did not take any drugs for hypertension, while there were twelve patients in the control group. The proportion of patients covered by the intervention taking medicines regularly was much higher than patients in the control group. The median of out of pbcket payment of patients in the treatment group was 20 Yuan which was lower than the control group（240.5 Yuan）. The blood pressure level of the treatment group was almost equal with the control group. CONCLUSIONS Patients covered by free medicine policy were more likely to take medicine regularly and the free medicine policy was useful to solve the problem of low-compliance caused by payment difficulty. Free medicine policy can help reduce the economic burden of poor patients with hypertension. The free medicine policy was not effective for the control of blood pressure and there were some problems in the implementation of the program.