Analysis And Research On The Current Situation Of Basic Drug System In Primary Medical Institutions In

1. ObjectiveTo study the influence of National System for Basic Pharmaceuticals on operation ofcommunity health service institution, to investigate the level of knowledge of national essentialdrug and satisfaction of community health service institution among outpatients and the level ofknowledge, attitude and practice of doctors from community health service in Guangzhou afterimplementing national essential drug system. Comparative analysis problems and achievementsof the implementation of National Essential Drug System in Guangzhou, and provide basic data,evaluation results for decision-making.2. Methods（1）Documentary research–collecting information of the implementation of EssentialDrug System domestically and abroad while analyzing the internal and external environments ofEssential Drug System.（2）Data Information Network system–From Data Information Network system extractthe data of health services and hospital income and expenditure of Community health service.（3）Cross-sectional survey–145community health service institutions were selected byTypical sampling from Guangzhou, While each select10doctors.1110outpatients were selectedby Typical sampling from eight districts in Guangzhou and all survey was conducted by aself-designed questionnaire.3. Results（1）Aspects of Outpatient services and Inpatient services, Community health serviceinstitution indicated a growing trend in guangzhou from2010to2012, the annual growth rae ofOutpatient services was16.53%, the annual growth rae of Inpatient services was24.87%. Peroutpatient costs was86.19yuan and85.56yuan respectively in2008and2012. Per outpatientdrugs costs was50.01yuan and47.99yuan respectively in2008and2012.（2）The annual growth rae of Outpatient services revenue, Inpatient services revenue andfinancial compensation revenue was23.40%,22.67%and22.33%, respectively, from2010to 2012in guangzhou. The proportion of outpatient drug revenue in total revenue was58.35%,52.64%and52.95%, respectively, from2010to2012, the proportion of inpatient drug revenue intotal revenue was37.37%,34.42%and33.48%, respectively, from2010to2012.（3）Community health service institution are equipped550kinds of basic drugs. This studywas selecting ten indicators to reflect the effect of NEMS evaluation, The shortest distancemethod was used to evaluate the influence. Community Health Center indicated a growing trendin guangzhou from2010to2012, the Operation in township hospitals achieve the best implementationeffect of NEMS in2011.（4）The level of knowledge of doctors on national essential drug was high,24.5%respondents were clearly aware of essential drug,60.5%were quite aware of essential drug. Theaverage score of respondents’ attitude was20.95±4.92. Subjects with different educational level,professional title, specialty, income and knowledge level of national essential drug system haddifferent scores (P<0.05). Logistic regression analysis showed that training times, age, incomeand knowledge level of national essential drug system was the influencing factor of doctors’practice.（5）The level of knowledge of national essential drug was low among outpatients inGuangzhou, Only55.1%respondents were aware of the essential drug system. Meanwhile theaverage score of outpatients’ satisfaction was15.30±2.51. Subjects with different age, region,occupation and medical expense had different score (P<0.05). Classified tree showed thatmedical expense region was the first important influencing factor of outpatients’ satisfaction,second was occupations.4. Conclusion（1）The influence of National Essential Drug System on outpatients was little, but has animpact on hospital services; large of patients perfor large hospitals not community health serviceinstitution;（2）Community health service institution are all equipped with basic drugs, but the list ofessential drugs was unscientific, varieties of drugs limited, and exists shortage problem. （3）Doctors are not acceptable for essential drugs, the positive of introduction to thepatient is not high; the satisfaction of outpatients is high, but the level of knowledge of nationalessential drug was low.