The Study On The Accessibility Of Essential Drugs In Nanjing And The Influencing Factors Of Priority Allocation And Use Policies

Objective:To evaluate and analyze the effect of the essential medicine system in Nanjing from the view of the accessibility of essential medicines.To investigate and compare the cognition and satisfaction of pharmacists and physicians of essential medicine system in hospitals of the second and third class in Nanjing,so as to provide reference and suggestion for how to give priority to the use of essential medicines.Methods:Survey of accessibility of essential medicines in Nanjing:according to the WHO and the international Health Action International(HAI)[1]standard drug price survey methods recommended by the 5 kinds high incidence of clinical disease as the research object,selects 24 kinds of essential drugs,sampling survey was carried out with the situation of Nanjing City medical institutions and social retail pharmacies.Investigation methods of knowledge,attitude and practice of physicians and pharmacists:self-designed questionnaire was used to investigate doctors and pharmacists from 15 hospitals in the city by convenience sampling.Results:(1)The essential medicine's availability in community hospitals of Nanjing is lower than the third level hospital no matter Lowest price generic or Originator brands.And essential medicine's availability in medical and health institutions is lower than social retail pharmacy.Within the same type of health care institutions,Lowest price generic are better than Originator brands in availability.(2)The affordability of essential medicines are good in Nanjing.There is a big gap of affordability level between Originator brands and Lowest price generic.Originator brand's affordability is worse.(3)The physicians' and pharmacists' average scores of recognition were 17.31±3.35 and 18.29±3.94(t=2.848,P=0.005);About the selection of antibiotics and traditional Chinese medicines in essential drugs,pharmacists' correct rates were respectively higher by 1.5 percent and 21.1 percent than physicians.The physicians' and pharmacists' average scores of familiarity for basic drug system were 15.73±3.62 and16.15±4.31(t=1.110,P=0.268).The proportions of physicians and pharmacists through professional training to understand the basic drug system were respectively 28.3%and 54.1%(t=31.497,P=0.000).Conclusion:Although the level of availability and affordability in Nanjing public hospital is not low,there is still much room for improvement.The implementation of the essential medicine system have been some achievements,but there is still a gap between expected.The pharmacists' and physicians' familiarity and recognition of the essential medicine system are in the middle level,and pharmacists are higher than physician in recognition.There are diffrences in the cognition of the accessibility of essential drugs between physicians and pharmacists.The majority of physicians have not participated in related knowledge training or learning,and more than half of the pharmacist understand the essential medicine system through professional training.Suggestions:All the medical and health institutions should improve the essential medicine' variety and quantity.And they should combine with the actual situation to improve the essential medicine bidding system,and adjust the original brands drug prices,reduce the treatment burden of the public.The government departments should update and adjust the essential medicine list according to the needs of clinical medicine.Optimizing the compensation mechanism,and increase the income of medical staff,strengthen the training of the national essential medicine system,and take appropriate incentive measures to strengthen physician and pharmacists'responsibility.Make sure to give priority to the use of essential medicine.