Encourage Rural Primary Health Care Sector Priority Essential Medicines And Practice Recommendations

Objective:Basic drug system has been in the government’s primary health care institutions and village clinics implemented in township hospitals use basic medicines reimbursement of hospitalization in some areas has reached 85% or higher, but the use of essential drugs in the clinic is still mostly at their own expense. Caused some outpatients in order to get reimbursed, it also requires hospitalization, increasing the waste of medical resources and increased the burden on Medicare. By basic Medicare reimbursement policy reform and improvement in primary health care institutions outpatient use of essential medicines reimbursed a certain percentage or all of the reimbursement can reduce inpatient, and make it to the upper part of the patient back to the hospital for treatment of primary health care institutions. Therefore, this study of rural grassroots medical institutions for outpatient therapy as a starting point for payment of reimbursement policies to promote research suggested priority essential medicines through reform and improve health care.Methods:Access to relevant documents, encourage understanding of domestic policy in the implementation of essential drug system. Early survey data consists of two parts, one is analysis of relevant data of the health insurance fund of Guangxi, the data information of the relevant data for 2011 provided by the Guangxi Autonomous Regional Health Planning Commission, in accordance with the funding levels and health development, taking six cities as a sample; the other part of the data is the 2012 field survey data, for township and village primary health care institutions, Using point, surface combined understanding of rural primary health care institutions essential drugs and Medicare outpatient reimbursement situation. Site survey in Guangxi Zhuang Autonomous Region select two new farming co-County Health Department, according to location and level of regional economic development, according to the good, bad, with stratified sampling was extracted from three township hospitals and three in each county village clinics for the study, while medical institutions were selected for each of the management staff, medical staff, pharmacy staff conducted a survey and qualitative interviews.Results:In 2011,55% region of rural grassroots medical institutions in Guangxi (province), outpatient drug costs accounted for the basic amount of the primary health care sector, inpatient use of essential drugs accounted for 45% of the amount of grassroots medical institutions, medical institutions at the grassroots level, basic outpatient drug costs use larger than inpatient costs usage. Village health essential drugs is greater than the amount of township health clinics dosage. Essential medicines grants general medical expenses and public health project grant income is greater than the cost of essential drugs clinic. In the county the actual reimbursement of medical institutions 46.26%, the actual reimbursement of 72.69 percent in the township hospitals, different levels of hospital reimbursement real big difference, township hospitals inpatient 37.21 percentage points higher than the county hospital. However, the use of essential drugs in the clinic is still mostly at their own expense. In 2012, in 12 rural primary health care institutions surveyed are all basic drug system, developed a management system of essential drugs. Respondents say the national essential drug system is better, the main problems are the lack of some commonly used drugs, drug delivery is not timely and low level of financial assistance.Conclusion:Now all use of essential drugs in rural primary health care institutions.2011 Guangxi township hospital inpatient reimbursement actually reached 72.69%, reimbursement policies range up to 80%. Inpatient reimbursement of essential drugs increased by 10 percentage points in the proportion of reimbursement on the basis of policy areas. Therefore, the use of essential drugs in the township hospital inpatient reimbursement rate has reached 90 percent Medicare reimbursement policies to encourage the purpose of the payment priority essential medicines. To study is currently in township hospitals and village health clinic room with basic drugs policy to support the use of essential drugs. Suggestions:First, the use of essential drugs free health clinic in the village first trial. The second is to improve the township hospital outpatient reimbursement use of essential drugs. Third, the implementation of related measures.