重庆市基本药物和绩效考核制度的实施现况调查

目的了解重庆市基本药物和绩效考核制度的实施现况,为政府相关部门科学决策提供依据。方法采用立意抽样方法抽取重庆市实施基本药物和绩效考核制度的19个社区卫生服务中心,采用问卷调查和小组访谈方法调查其机构负责人。结果 19个机构全部实施基本药物和绩效考核制度,47.4%的机构配全基本药物,42.1%的机构非基本药物全部下架;15.8%的机构门诊量增加,大医院转回社区的患者有78.9%不能在社区开到所需药品;84.2%的机构收入减少,68.4%的机构职工收入减少;84.2%的职工对绩效考核不满意。结论基层卫生急需综合配套改革。基本药物目录的制订需要充分调研并进行动态调整,大医院与基层同步推进,以保证服务连续性。应在落实基层卫生机构补偿基础上实施绩效考核,同步推进人事制度改革。

Implementation of Essential Drug System and Performance Appraisal System in Chongqing

Objective To investigate the effects and challenges after implementation of essential drug system and performance appraisal system in Chongqing.Methods Altogether 19 community health service centers where essential drug system and performance appraisal system had been implemented were selected using purposive sampling method.Questionnaires and group interviews were conducted among the staff in charge.Results Out of the 19 organizations,47.4% prescribed all essential drugs,42.1% had disposed of all non-essential drugs,and 78.9% of the downward referral patients could not obtain their needed drugs in the community health service centers.Number of outpatient visits increased in 15.8% of the organizations.Revenue decrease and staff salary decrease occurred in 84.2% and 68.4% of the organizations,respectively.About 84.2% of the staff were not satisfied with the current performance appraisal system.Conclusion Reform on essential drug list and human resources should be carried out in a more comprehensive manner.The essential drug list should be appropriately established and adjusted;meanwhile,it should be simultaneously implemented in hospitals and community health care organizations to ensure health care continuity.Performance appraisal system should be implemented along with basic health organization compensation system.