| [Purpose]Analyze the current status of Community Pharmaceutical Care(CPC),provision in Wuhan community health service institutions from both aspects of supply and demand,introduce the Donabedian health assessment model to build a comprehensive evaluation index system for CPC,and conduct a comprehensive evaluation of the CPC provision in each administrative area of Wuhan.Identify problems and discuss influencing factors,so as to put forward targeted improvement strategies for the development of CPC in Wuhan.[Methods](1)Literature analysis: Literature methods are used to access online literature such as Web of Science,Pub Med,Wanfang Chinese Database,CNKI How Net,and other related literature in the database.Retrospective analysis and summary of the theoretical research and practice of CPC development at home and abroad,to provide reference basis and theoretical basis for designing research programs and survey tools.(2)Empirical research: This survey was conducted from two levels of each institution.Using the stratified random sampling method,a total of 70 institutions were sampled from the four types of community health service centers,namely government-run,university-run,enterprise-run and private-run,for a total of 70 institutions to conduct on-site investigations.The pharmacy staff and medical staff in the institution conducted a full sample survey.At the same time,a random encounter method was used to conduct a questionnaire survey on 30-35 real residents who came to the institution.(3)Data analysis: The SWOT analysis method was used to analyze the development environment of CPC,and descriptive analysis and statistical methods were used to analyze Collected various questionnaires and questionnaire data for analysis,and provided a description of the current status and influencing factors of CPC provided by Wuhan community health service institutions.The TOPSIS comprehensive evaluation method and RSR method was used to synthesize the CPC delivery status based on the Donabedian health evaluation model.Based on the evaluation index system,comprehensive analysisand evaluation of the provision of CPC in each administrative district of Wuhan City was conducted to obtain a comprehensive score and ranking.[Results](1)Analysis of the current status of CPC provision in Wuhan from multiple perspectives of both supply and demand.From a supply perspective: the study found that the current The various guarantee mechanisms provided by CPC are not yet perfect,especially the difficulties and obstacles in financial support,supporting facility construction,and drug supply guarantee.At the same time,the functions of community pharmacists have not been fully exerted,and the form of CPC provided is relatively simple.And superficially,it is not common enough to participate in the family doctor contract service team and the health management of the elderly and chronic diseases;from the perspective of needs:community patients generally do not trust community pharmacists,and are more inclined to obtain more convenient and personalized CPC,a comparison found that there is still a gap between the current CPC provision and the needs of community patients.(2)Analysis of influencing factors of CPC provision in Wuhan: The academic qualifications of community pharmacy personnel have the most significant effect on the cognition and competence of CPC;the host and the administrative district have a significant impact on the income of the community pharmacy staff;And the nature of the city has a significant impact on the participation rate of contracted services of family doctors and chronic disease management in community pharmacy staff.(3)Construction and evaluation results of the comprehensive evaluation system of CPC provision in each administrative region of Wuhan: Under the framework of Donabedian health evaluation model,a comprehensive evaluation index system that conforms to the characteristics of CPC development is constructed and evaluated.The results found that the development of CPC in each administrative district of Wuhan was quite different.The development process of CPC was different,the quality was different,and the effects were different between the districts.[Conclusions]At present,the CPC is in an environment where rapid development needs to coexist with many problems,opportunities and challenges.Although still facing many problems and disadvantages,with the support of policies,strong demand and the development of new technologies such as Internet new media,the development of CPC should be given full attention.The current development of CPC in Wuhan is still facing many difficulties and problems.There is an urgent need to improve the protection of people,finances and things,and expand the functions of community pharmacists.At the same time,it is necessary to use graded diagnosis and treatment and family doctor signing And other opportunities such as policies and the development of Internet technology to continuously enrich the content and form of CPC,and improve service quality and service levels.At present,the administrative districts in Wuhan lack uniform CPC standards.It is suggested that service standards and evaluation standards should be formulated as soon as possible in accordance with the actual situation to promote the homogeneous and high-quality development of CPC in the region.[Innovation and Limitation]Innovation: In this study,a full sample coverage survey was conducted on the community health service centers in Wuhan,and the Donabedian health evaluation model was introduced to build a comprehensive evaluation index system.The two comprehensive evaluation methods were combined to carry out the pharmaceutical service provision of community health service institutions in various administrative regions of Wuhan.Comprehensive evaluation;Insufficiency: Affected by the difficulty of obtaining data and the actual poor development of community pharmacy services,the research design may not be scientific and perfect. |
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