| BackgroundPopulation aging is a critical challenge for economic and social development of our country.In 2017,the proportion of the population over 65 years old in China has reached 11.40%.The elderly population has a high incidence of chronic diseases and need long-term medical treatment.In order to ensure the basic medication for the mass and ease the burden of medicine expenses,national essential medicine system was established and implemented in 2009 in China.Essential medicine should be equipped and used by all primary medical health care institutions organized by the government and also other types of medical institutions.Therefore,it is of great practical value to carry out cognitive research on the national essential medicine policy for the elderly,so as to improve the accessibility and availability of essential medicine.Research ObjectiveTo understand the current cognitive situation of the essential medicine policy of the elderly,the cognitive attitude towards the use of essential medicine for free and the willingness to choose essential medicine for free in primary medical institutions,and to analyse their influential factors,providing the relevant countermeasure and suggestion,so as to improve the top level design of essential medicine policies and increase the availability of essential medicines.Material and MethodsSamples were selected using a multi-stage random sampling method,and self-made questionnaire were used to collect data through face-to-face interviews.A total of 7070 elderly people aged 60 years old and above were investigated in this study.The content of the survey mainly include population sociological features,economic status,life style,physical health status,cognitive status of the elderly regarding essential medicine policy,the cognitive attitude of the elderly towards the use of essential medicine for free and the willingness of the elderly to choose essential medicine for free in primary medical institutions.Statistical analysis was performed using SPSS 21.0.Research Results(1)Among the 7,070 elderly people,40.25%were male and 59.75%were female;The average age was 69.81±6.45 years old;Those aged between 60 and 69 accounted for 52.42%,and those aged between 70 and 79 accounted for 38.97%;32.11%of the elderly did not go to school,41.36%went to primary school,high school or above only accounted for 7.93%;Elderly people in marriage account for 81.17%;30.78%were employed(with labor income)and 48.46%were unemployed(without income).Before the age of 60,77.50%of the elderly were agricultural,forestry,animal husbandry,or sideline fishing workers;Those with medical insurance accounted for 98.37%,among which those with primary medical insurance accounted for 56.05%;Only 1.41%had commercial medical insurance;The proportion of empty nests was 37.75%;Rural elderly accounted for 70.58%.(2)Medical and drug treatment of the elderly:For common/frequently encountered diseases,72.77%and 65.88%of the elderly chose to go to the village clinic/community health service station for medical treatment and drug purchase,and 13.85%and 16.66%chose to go to the township health center/community health service center for medical treatment respectively;50.51%of the elderly tended to choose oral treatment,and 40.07%of the elderly tended to follow the doctor's advice when using drugs;While the elderly went to primary medical and health institutions for medical treatment,60.93%of doctors did not recommend drugs for the elderly.47.37%of the elderly considered that drugs from primary medical institutions were of great help to cure diseases,32.96%of the elderly considered that it has played a great role.2.72%of the elderly were affected by drug advertisements while buying drugs,and only 0.98%of the elderly bought drugs online.(3)Cognitive status and understanding approaches of essential medicine policy for the elderly:only 11.58%of the elderly understood the national essential medicine policy,and the main understanding approach was the introduction of doctors.Single factor analysis showed that the elderly with non-empty nest,lower age,higher level of education,retirement(retired),higher level of personal annual income,higher level of personal consumption expenditure,daily physical exercise and physical examination within nearly one year had higher awareness rate.Multiple factors analysis showed that age,education level,personal annual income level and consumption expenditure level were the main factors influencing the awareness rate of essential medicine policy of the elderly.(4)Cognitive attitude of the elderly towards the use of essential medicine for free in primary medical institutions:98.08%of elderly people held a supportive attitude towards the use of essential medicine for free in primary medical institutions.Single factor analysis showed that the elderly with non-empty nest,lower level of personal consumption expenditure and higher self-paid medical expenses had a high support for use of essential medicine for free in primary medical institutions.Multiple factors analysis showed that empty nest,level of personal consumption expenditure and self-paid medical expenses were the main factors that has affected the elderly support the use of essential medicine for free in primary medical institutions.(5)The willingness of the elderly to choose essential medicine for free in primary medical institutions:96.28%of the elderly were willing to buy drugs from primary medical institutions if the policy of use of essential medicines for free was implemented.Single factor analysis showed that the elderly with non-empty nest,employment(with labor income),living in rural areas,relatively rich self-assessment economic status,higher self-paid medical expenses,no chronic diseases,and self-assessment body painless or without discomfort were more likely to buy drugs in primary medical institutions;Multiple factors analysis showed that the current condition of employment,self-assessment of economic status,self-paid medical expenses,and chronic disease status influenced the elderly to buy drugs in primary medical institutions.Conclusion and SuggestionsThe elderly people in Shandong province have a low level awareness of the national essential medicine policy,a high support for use of essential medicine for free in primary medical institutions,and tended to go to primary medical institutions for treatment of common/frequently diseases.Moreover,most elderly people were willing to buy drugs in primary medical institutions.According to the analysis results,countermeasure and suggestions are proposed as follows:firstly,strengthen the essential medicine allocation and pharmacy practice capacity building of primary medical institutions,and also improve the availability and accessibility of medicine;Secondly,improve the cognitive level of essential medicine policy of the elderly by enhancing the propaganda work of doctors in primary medical institutions about the national essential medicine policy,thus promoting the use of essential medicines in the elderly.Thirdly,strengthen the top-level design of the essential medicine system,developing the policy research and pilot work on the use of essential medicine for free in primary medical institutions,so as to achieve full coverage of essential medicine and effectively ease the drug burden on the elderly. |
PDF Full Text Request