Study On Implementation Effect Of Essential Medicine System In Dalian

Objective: The objective of this research was to understand the status andproblems of Essential Drug System in DaLian using survey technique. And base on theproblems, some suggestions for improvement were put forward to provide the referencein the formulation, revising policies and evaluating implementation effect.Methods:1. Using reference research to construct basic frame and pattern of thequestionnaire, at the same time ascertained the pool of basic indicator to be chosen.2.Using Delphi expert consulting research method to select some indicators forimplementation effect of essential medicine system.3. Using the data collected frompre-investigate to check the reliability and validity, the reliability was internalconsistency reliability; The validity was structural validity coming from the factoranalyze; the comprehensive evaluation was the non-integer rank sum ratio test; doingthe factor analyze for the weight of indicator.4. Revised the questionnaire in the light ofthe pre-investigate, then began the formal investigate.5. Statistic methods: using Excelto import the data, and using SAS9.2for the reliability and validity and somedescriptive of data, then undergone tests for normality and for homogeneity of variance,compared the differences from different group, determined the weight of indicator forcomprehensive evaluation, and did the non-integer rank sum ratio in different primaryhealth care institutions.Results: After the reference research, there were some basic indicator in pool;then after the Delphi expert consulting, the final indicators were obtained, finally afterthe discussion of the consulting team, the forms were fixed, such as interview,questionnaire. The data of pre-investigate showed the questionnaire had good reliabilityand validity, after revision the questionnaire we began the formal investigate. Theresults were as follows: Patients had53.0%awareness of Essential Drug System, and in which the satisfaction was57.6%. The average expense of outpatients with chronicdisease (e.g. hypertension, diabetes) were no significant difference; for Upperrespiratory tract infection, it was significantly disease; but for these diseases, the theaverage number of medicines per prescription were no significant difference. In averagemedical expense per outpatient, the percentage of medicine charges decreased9.7%,and the percentage of medicine charges was12.4%higher than the national average.Visits and Income increased; The percentage of drug income were decreasing year byyear in the business income and in the overall drug income, but the revenue structurestill need to be adjusted. The results of compensation evaluation show that fifth CHSC(Community health service center), seventh CHSC and eighth CHSC were the mosteffective in implementing the work, but first CHSC and third CHSC were less effective.The simple linear regression model was significant, and there is no statistical evidenceagainst the homogeneity of variance, the multiple comparisons were significant.Conclusion: The findings demonstrated essential medicine system made preliminaryprogress in PHCs (PHC, primary health care institution) of DaLian, not only achievinguniversal coverage but also solving the issue of inadequate and overly expensivemedical services to some extent. And Pay close attention to the following in the future:Increased publicity, Additional varieties of essential drugs, optimize compensationmechanism, improve compensation mechanism, and so on. After formal investigate, thequestionnaire established during this research showed it had high reliability and validity,it could scientifically explain the real situations. At same time this model ofcomprehensive evaluation was very easy to perform, it could be easily used to performin practice, and using the results of comprehensive evaluation to provide a reference inthe formulation, revising policies and evaluating implementation effect.