Study On Essential Medicine List For Community Health Service Center

Health care cost rises fast in recent years, among that the drug cost possesses more proportion in total health care expenditure. Simultaneously, there are defects in the fairness and accessibility of health, which impact enormously on the implementation of the objective of "Primary Health Care for All". "Inadequate and overly expensive medical services" has become to be an important issue that influences the establishment of harmonious society. To solve the issue of "Inadequate and overly expensive medical services", retrieve the behavior of irrational utilization of drugs, reduce waste, control drug consumption, fundamentally restrain the fast growth of drug cost, facilitate fair and rational utilization of health resources, we should carry out health care reform, establish Essential Medicine List, and practice essential medicine policy, from which we can improve the fairness and accessibility of health care, and implement the objective of "Primary Health Care for All" with limited fund and health resources.The concept of essential medicine was proposed by WHO in 1975, which aimed at warranting the provision of essential medicines for most people of the member countries, especially developing countries. Essential medicine can not only satisfy the demand for disease prevention and disease treatment, but also it can facilitate the efficient utilization of limited health resources, from which to achieve optimal social benefit and economic benefit. Community health service is the basis of urban public health and basic medical service system, is the primary provider for medical service, and is an important ingredient of community construction. Community health service is the carrier of primary health care. The development of community health care is a valid approach to implement health care fairness and accessibility. It is significant to develop community health service for the implementation of "Primary Health Care for All", the solution of the issue of "Inadequate and overly expensive medical services", and the establishment of harmonious society. Therefore, according to the extensive applicability of the concept of essential medicine, the Essential Medicine List should reflect the requisition and techniques of infrastructure constructions of health care in different levels. Based on the different spectrum of disease in different locations, and the factors about heredity, geography and environment, we can formulate correspondent Essential Medicine List.As yet, we haven't found any study on Essential Medicine List for Community Health Service Center. Therefore, we carried out this study. The main objective of this study is to formulate Essential Medicine List for Community Health Service Center, which is based on the concept of essential medicine proposed by WHO, uses the principles and procedures for the formulation of WHO Essential Medicine List, basing on National Essential Medicine List and referencing National Basic Medical Insurance Medicine List, and gets the message of spectrum of disease of inhabitants of Ji'nan, Shandong Province.Based the guidance of basic principles of essential medicine, the study discussed the essentiality for the formulation of Essential Medicine List for Community Health Service Center thoroughly. Simultaneously, according to the knowledge of the spectrum of disease, we formulated the Essential Medicine List for Community Health Service Center using the principles and procedures of WHO Essential Medicine List, basing on National Essential Medicine List and referencing National Basic Medical Insurance Medicine List. The list was congruous to the practical work of community doctors. 13 community health service centers were chosen in the study to collect data. The methods used in the study are literature review, Delphi, field investigation.Main findings of the study are: ( i) the main is drug income in professional income(60.97%), which is the main in total income(58.82%), and also the main expenditure is drug expenditure in professional expenditure(35.46%); (ii) there are a great variety of drugs in community health service centers, 343.50 western medicines and 119.50 Chinese traditional medicines are included; (iii) the spectrum of disease of habitants is in accordance with National Community Health Service Investigation in 2003; (iv) based on the spectrum of disease, we formulated the Essential Medicine List for Community Health Service Center referencing WHO Essential Medicine List, National Essential Medicine List and National Basic Medical Insurance Medicine List. The Essential Medicine List for Community Health Service Center contained 354 items, which included 223 Western medicines and 131 Chinese patent medicines.Recommendations are summarized below according to the study, including: (i) the spectrum of disease, diathesis of medical staff, sources of fund, heredity, geography, environment and so on should be considered in the formulation of Essential Medicine List for Community Health Service Center; (ii) the method used to formulate Essential Medicine List for Community Health Service Center is Delphi method for the first time. However, the Pharmacoeconomic evaluation data, Evidence-based Medicine data and so on should be used to select essential medicines in the future. Therefore, we should pay more attention to the collection of related data, (iii) the formulation of Essential Medicine List for Community Health Service Center is only the first step. Whether or not the essential medicine can facilitate rational utilization of drug, diminish waste, improve the procurability of drugs, facilitate the accessibility and fairness of health care, implement the objective of "Primary Health Care for All" with limited health resources, we should pay attention to the manipuility and feasibility of Essential Medicine List for Community Health Service Center. Then, the practice of National Essential Medicine Policy is needed, which can warrant the manufacture and provision of drugs. Simultaneously, we should strengthen the training of community doctors, formulate and practice clinical guidelines and hospital formularies.