| Object:This study investigated the construction of medicine cost in rural areas of Anhui.This study is also explored certain facts influencing the change of expenses and their degrees respectively,in order to control the unreasonable increase of expenses. This study provided some suggestions on the national drug policies and policies of New-type rural cooperation medical system,in order to improve rational use of drugs in rural areas and ensure the ration use of drugs policy be effective in a sustainable way.Data and Methods:Literature review,field investigation,expert consultation and statistical method were used in this study.The data included:(1) Literatures of hospitalization cost control in China and abroad.(2)Comprehensive date on counties which with the policy of New-type rural cooperation medical system,including:date of local population,situation of macroscopic economy,financial situation of local system of health management.(3) The data of New-type rural cooperative medical system experimental countries,including the data of inpatient medical record and list of medical cost of 20 health facilities in 5 project counties from 2005 to 2006.We selected 984 cases of Appendicitis,Hysteromyoma tumor,Cholecystitis,Cerebral thrombosis,Pneumonia and Alimentary canal canker as sample and using factor analysis to study expenses result factors.Result:Residential day is proved to be the main factor of expenses.Suggestion:To control the residential day promptly and scientifically and to prevent syndrome of more common diseases. This study content included:(1) study on component of hospitalization cost in New-type rural cooperative medical system experimental institution.(2) Analysis on influencing factors of hospitalization cost.(3) Study on strategies to apply interventions.Results and Conclusions.1.By reviewing and summarizing the literatures and date of this investigation,analyzing the mean,median,stranded deviation of every indicator, the researcher found component of hospitalization cost in New-type rural cooperative medical system experimental institution is as follows:cost of drug 43.57%,cost of surgery 19.47%,cost of cure 16.20%.2.The health administrations in the investigated area have taken some methods,such us standard treatment guideline(STG),essential drug list(EDL) of Anhui New-tape cooperative medical care system(CMS).And it have some rational effect.According to the result of the investigation,in the experimental areas,percentage of essential drugs is up to 96.35%in average.Meanwhile,in the other areas,the percentage is only 94.21%. In the experimental areas,percentage of essential drugs of the patient who participated in the New-tape cooperative medical care system is up to 95.64%.Those was not involved in New-tape cooperative medical care system only has a percentage of 97.91% in average.It is a little larger rate compared to the people of CMS,but statistically,it is not a significant difference.The result indicated that the application of the CMS policy have changed the conduction of drug use in investigated areas to some extent,but the conduction of medical institution has not changed according to payment form of patients.In another words,it have not enough evidence to say the compensation system in CMS lead to irrational expenditures in patients cost.The drug cost in the medical institutions of county class is RMB 1046.9 yuan in average,which is much more than in those of rural class,RMB 639.4 yuan in average. level.However,behavior of irrational use of drugs happened in medical facilities at town level concern more about being withno obvious effect,using medicine deficiency, irrational match of drugs.That unreasonable cost mostly increased in the patients suffering with cerebral thrombosis,those patients with pneumonia and cholecystitis follows.In treating the cerebral thrombosis patient,there are abundant new medicines to be selected,and many of them are not in the drug catalogues of cooperative medical care.And there are more difference in its price,in the end lead to a more unreasonable cost.4.The result of step-by-step regression analysis shows that 5 independent variables are entered the equation,which reflected the facts out of 8 independent variables are affected the hospitalization cost.According to the distance of influence,the effect cost arrives as follows,days living in hospital,rank of medical institution,kind of disease, economic index in the area and sex of patient,the standardizes return modulus being 0.410,0.227,0.106,0.077,0.065 respectively.5.From factories to customers,the price of medicine can be summarized as the cost price,leave factory price and throwing into price(is hit by catalogue),actual price, wholesale price and retail price.Most medicines and chemical reagents of our country all is to copy medicines and chemical reagents,whose cost of production and research cost are comparatively low,but medicines and chemical reagent's circulating cost, purchasing cost and using cost is much higher,and as a result led to the high price of medicines and chemical reagents.Suggestions:1 Increases the government's investment,reinforces to the strength that supporting the medical institutions at county level and town level. 2.Make the reimbursing percentage reasonable and work out the policy to make it more easy for patients to change to another medical institution.3.Taking precautions action against the disease which leading to a height cost and with a high occurrence ratio in population.4.Reinforce the education of medicines and chemical reagents regulation and training of rational drug use,improves business of medical establishment personnel ability.5.Put medicine price system in good order;improve medicines and chemical reagents make chemical reagents price in a scientific and transparency way.6.Guarantee the medicine in the basic drug content to be supplied by the pointed manufactories and reduce the stages in delivery.7.The policies of health care and the policies of medicine are innovated mutually;to optimize the registration and uses of the basic medicine.
|
PDF Full Text Request