| Background: On October 25,2018,the National Health Commission released a new National Catalogue of Essential Drugs.As the core of the rural three-level medical network,the county-level public hospitals are the main battlefield of the implementation of the essential drug system.Over the past two years since the implementation of the catalogue,whether to play the policy guiding role of the catalog is worth exploring.Objective: To evaluate the implementation effect of the 2018 edition of county-level hospitals of Hubei Province,put forward some targeted opinions and suggestions,and provide some reference for further improving the implementation of the 2018 edition of county-level hospitals in Hubei Province.Methods: On the basis of literature research,from the use of county medical institutions,prescription,rational drug use,procurement of essential drugs,pharmaceutical department cognitive four aspects of questionnaire design,questionnaire,targeted interview,collect data and analysis,compare the new version of essential drugs directory before and after the implementation of the changes.Results:(1)For the 2018-2020 years,The average allocation rate of basic medicine articles is 45.0%,46.8% and 49.8%,respectively,Average amount of essential drugs is 32.7%,36.0% and 42.7% respectively,Average is 27.2%,26.2% and 25.6%,respectively,The average outpatient visits is 412,000,461,000 and 392,000,The average total discharge was 41,000,45,000 and 34,000,Average outpatient costs is59.4,61.4 and 66.4 respectively,The average average drug cost for hospitalization was 1630.0,1723.9 and 2075.0,respectively.(2)During the same period from 2018 to October 2020,the average number of outpatient prescriptions was 2.1,2.1 and 2.0,respectively,and the average amount of the prescription drugs was RMB 94.1,RMB 104.2 and RMB 120.0.The proportion of antimicrobial prescriptions was 18.8%,17.6% and 14.5%,the average use of injections was 12.3%,11.3% and 10.0%,and essential drugs accounted for 45.8%,47.0% and 49.4% of prescription drugs,respectively.(3)Among the three batches of selected varieties purchased by the state,the proportions of essential medicines were 72.5%,69.7% and 62.6%,and the proportions of essential medicines were 57.2%,59.9% and 69.8%.(4)25.9% of respondents were very familiar with the new version of essential drugs,55.6% believed that the catalog varieties could meet the basic drug needs of the hospital,and 74.1% were satisfied with the use of essential drugs in the hospital.The implementation of the new essential drug catalog,85.2% of respondents believed that it could promote rational clinical drug use,and 92.6% believed that it was conducive to the construction of the hierarchical diagnosis and treatment system.Conclusion:(1)The proportion of the 2018 version of the National Basic Drug Catalogue in a municipal and county-level medical institution has increased year by year,which has also achieved the growth of medical income,the increase of medical treatment and the proportion of drug continuous decline.However,there are also the problems of the proportion of basic drug allocation and the amount of use,and the increasing drug burden of patients.(2)The implementation of the 2018 edition of the National Basic Drugs Catalogue has improved the reasonable medication level of outpatient prescription in a city-county medical institutions at a city and county level,reduced the number of prescription drugs,reduced the proportion of antibiotics and injections,the proportion of basic drugs increased,but the proportion of basic drugs prescriptions is not high and the average prescription fee has increased.(3)When the implementation of the national drug procurement policy with quantity,non-essential drugs occupy a certain proportion of the selected varieties,which may affect the proportion of the allocation and use of essential drugs in medical institutions at a city and county level.(4)As the direct manager of the pharmaceutical work of the hospital,the head of the pharmaceutical department's lack of cognition of the essential drugs may have an adverse impact on the implementation of the essential drug policy.(5)The implementation effect of the essential drug policy is affected by various factors.It is necessary to improve the relevant policies and take comprehensive measures to fundamentally solve the problems to ensure the smooth implementation of the policy.Suggest: Improve the national essential medicine catalog,strengthen the management of the equipment and use of essential medicines,enhance the ability to guarantee the supply of essential medicines,improve the reimbursement policy for essential medicines,strengthen the assessment of the rational use of essential medicines,increase the promotion and training of the essential medicine system. |
PDF Full Text Request