Research On Design Of Pharmaceutical Service Package In Primary Medical Institutions And Implementation Strategies

Objectives:In order to design a pharmaceutical service package for the primary medical institutions like the basic medical and health service package,the pharmaceutical services which are suitable for primary medical institutions in China are selected and combined by referring to the typical primary pharmaceutical service models in foreign countries based on the in-depth study of the characteristics of drug use,the current situations of supply and demand of pharmaceutical services and the actual supply capacity of pharmaceutical services of primary medical institutions in China.At the same time,according to the pharmaceutical service package above,strategies for promotion and implementation of the pharmaceutical service package at national level are proposed,which will ensure the implementation of the pharmaceutical service package and effectively improve the level of pharmaceutical service in primary medical institutions.Methods:First of all,the current status of pharmaceutical service of primary medical institutions in China,the typical models of primary pharmaceutical service in foreign countries and the existing related medical and health policies in China were systematically reviewed,summarized and analyzed through literature research,and initially extract the suitable pharmaceutical service projects for primary medical institutions in China.Secondly,the key informants,such as relevant personnel of the health administrative departments,persons in charge of primary medical institutions and relevant research scholars in the field of pharmaceutical management were interviewed deeply to screen and adjust the contents of primary pharmaceutical service projects initially formed.In addition,extensive research were conducted on the necessity of pharmaceutical service projects in primary medical institutions in China,the ability to provide pharmaceutical services and the knowledge and needs of patients for pharmaceutical services from the perspective of different stakeholders via pre-trial and questionnaire surveys,which let us fully understand the supply and demand status and service capabilities of pharmaceutical services of primary medical institutions,and provided empirical evidences for the design of pharmaceutical service package in primary medical institutions.Finally,based on the results of empirical research,we proposed the contents and implementation strategies of the pharmaceutical service package of primary medical institutions in China by fully learning from the Community-based Pharmacy Service Model of United Kingdom and the Medication Therapy Management of United States(MTM),as well as referring to the characteristics of drug use and the current states of pharmaceutical service in primary medical institutions in China.Results:First,regarding to the primary medical service capabilities,the primary medical institutions have the characteristics of large quantities,multiple services and multiple outpatient visits.There are differences in the service capabilities of primary medical institutions in different regions.The medical service capabilities of village clinics,community health service stations,township hospitals and service centers are varied greatly.Second,respecting to the primary pharmaceutical service capabilities,the primary medical institutions need to strengthen their guidance of drug use and the allocation of medications.Primary medical institutions have equipped with pharmaceutical personnel,but their professional qualities need to be improved.And the training of primary medical institutions'staff needs to be polished up.Thirdly,with regard to the contents of primary pharmaceutical service,the degree of acceptance of pharmaceutical service packages is relatively high,and it is a general demand for doctors,pharmacists,and patients.The demand for basic pharmacy service items is relatively high,which is easier to carry out as well.There are some demands for clinical pharmaceutical services,but supervision and development need to be supervised.Fourth,with respect to the targets of primary pharmaceutical service,patients visiting primary medical institutions are characterized by low levels of incomes,education and medical insurance.The awareness of basic medicines and pharmacists is low for patients attending primary medical institutions.And the patients have little demand for improved pharmaceutical services in primary medical institutions.Conclusions and Suggestions:Regarding to the contents of pharmaceutical service package,the pharmaceutical service package of primary medical institutions designed finally covers 6 categories and 21 subcategories of pharmaceutical service projects and is divided into basic pharmaceutical service projects and additional pharmaceutical service projects.The implementation strategies of pharmaceutical service packages in primary medical institutions mainly includes macro and micro levels.At the macro level,cooperating the original intention of policy and strengthening the linkage effect of related policies-overall orientation,focusing on the construction of pharmacy services and raising the level of rational drug use-service objectives,clarifying the contents of pharmaceutical services at the national level and realizing scientific dynamic adjustment-specific content,formulating the plan of pharmaceutical service and focusing on the guidance of primary medical policies-institutional guarantees,nurturing pharmaceutical technicians and filling the gaps of staffs in primary medical institutions-talent supports,advancing science popularization of pharmacy and expanding the sphere of influence of pharmaceutical service package-public opinion guarantees.At the micro level,pilot and promotion of the pharmaceutical service package system:focusing on the differences of areas and advancing step by step,financing model of the pharmaceutical service package system:finance securing and medical insurance complementing,executive bodies of pharmaceutical service package:managing comprehensively and strengthening the capability of primary medical institutions.