上海市公立三级综合医院医药分开试点对门急诊用药行为的影响.pdfVIP

Chinese Joumal of Health Policy , June 2016 , Vol. 9 No.6 ·医院管理· 上海市公立三级综合医院医药分开试点对门急诊用药 行为的影晌 苏澎I • 段光锋I 倪思明2 许宏3 田文华4 1.第二军医大学卫生勤务学系 上海 2∞433 2. 上海市医疗保险协会 上海 2∞052 3. 上海市人力资源和社会保障局 上海 2∞125 4. 复旦大学社会发展与公共政策学院 上海 200433 【摘 要】目的:分析和评估医药分开政策对公立三级综合医院医生门急诊用药行为的影响。方法:从医 保角度，对4 家试点医院和3 家对照医院的医生门急诊用药行为进行对比分析。结果:平均每张处方用药品 种数、注射剂使用率、基本药物使用率差异不明显，抗菌药使用率试点医院明显低于对照医院;平均每张处方 药品费用试点医院高于对照医院，但是处方率试点医院低于对照医院。结论:医药分开政策尚未对医生的用 药行为产生明显影响;从医生及患者的用药习惯、药品供销的利益链及医药分开试行范围分析可知，促进医生 合理用药仍需综合多方措施。 【关键词]公立三级综合医院;医药分开;用药行为 中图分类号:R197 文献标识码:A doi: 10. 3969/j. issn. 1674-2982.2016.06.003 EtTects of separating drug sales from medical services on the prescribing behavior among out- patients and emergency services in the general tertiary public hospitals of Shanghai 1 SU Peni , DUAN Guang乔ng , NI Si-mini , XU Honi ， πJtN Wen-hω4 1. Faculty of Health Seroice , the Second Militαrγ Medical University , Shanghai 200433 , Chinα 2. Shanghai Health Insurance Associαtion ， Shanghαi 200052 , China 3. Shanghai Municipal Human Resources and Social Secunty Bureau , Shαnghai 200125 , Chinα 4. School of Social Development αnd Public Policy , Fudan Un加ersity ， Shαnghαi 200433 , China [ Abstract] Objective: To analyze and evaluate the effects of separating drug sales from medica1 services on the prescribing behaviors among outpatient and emergency services in the general tertiary public hospítals. Methods: From the perspective of medica1 insurance , the above mentioned prescribíng behaviors were analyzed between four pi- lot hospitals and three control hospita1s. Results: There was no obvious dífference in the average number of drugs per prescription , the rate of injection usage , and the rate of essential drugs utilization. Th