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Investigation and Valuation on the Rationality of Drug Use in Feixi Township Hospitals Under the Background of the New Medical Reform

Author: HuangPuMing
Tutor: LvXiongWen
School: Anhui Medical University,
Course: Pharmacology
Keywords: Comprehensive reform of the health system Rational use of drugs Antimicrobial agents DDDs Township hospitals Drug prices The new rural cooperative medical care Basic medical insurance
CLC: R197.1
Type: Master's thesis
Year: 2011
Downloads: 105
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Abstract

In December 2009, Anhui comprehensive reform of the primary health system (referred to as the new health care reform) was the first in the country to start. The most prominent feature of the primary health care reform in Anhui Province is through grass-roots medical and health system reform, promote the establishment of basic drug system. Implementing drug \Foreign essential drug system implemented for many years practice shows that the essential drugs policy implementation success, there is close contact between the ability to increase the level of rational drug. The pilot units of township hospitals medication reasonable understanding of the comprehensive reform of the primary health system, this paper research Feixi the the eight township hospitals medication the status of, and analysis and evaluation of the medication reasonable to further establish and improve the basic drug system provide a reference. The specific content of this study: (1) the status of the drug investigation using random sampling method to extract from Feixi 28 township hospitals in eight township hospitals, were from eight township hospitals in October 2009 and 2010 October electronic prescriptions (including acute and outpatient prescriptions and inpatient prescription) each random sample of 100 prescriptions. Survey of the eight township hospitals medication existing state, including essential drugs varieties, new IICA varieties, Medicare CPI (A), (B) varieties proportion. The results show that the medical reform, every one hundred kinds of prescription drugs, the proportion of essential drugs has increased, rising from 59.4% of the health care reform to 67.6% of the health care reform; new IICA drugs utilization rate, the CPI Medicare Drug usage are on the rise, from 77.8% of the health care reform, respectively, 60.2% to 84.7% of the health care reform, 65.4%; health insurance B drug usage declined slightly, from 27.5% of the health care reform down to 24.4% of health care reform. Medication reasonable evaluation based on preliminary understanding of Feixi township hospitals medication, of Feixi township hospitals medication reasonableness of the investigation and analysis. Using random sampling method to extract 8 Feixi township hospitals, and then were each randomly selected from the eight township hospitals between October 2009 and October 2010 electronic prescribing (including acute and outpatient prescriptions and inpatient prescription) 100 prescription. Part of the international research in rational drug use indicators recommended by WHO and its own index analysis of medication reasonable. The results showed that eight integrated township hospitals Overall, compared with the health care reform (2009), health care reform pilot at each visit (2010) the average drug costs decreased from 60.1 yuan to 31.0 yuan, with a statistically significant difference (P lt ; 0.01); single prescription average number of drugs decreased from 3.8 to 3.6; higher proportion of every one hundred cases of treatment use of antimicrobial agents, 71.3% and 69.6%, respectively; every one hundred kinds of prescription drugs, basic drugs the percentage of utilization rate increased from 59.4% to 67.6%; basic drug expenses as a percentage of the cost of prescription drugs increased from 43.6% to 50.4%; every one hundred cases of treatment using the injection ratio decreased from 56% to 46.1%; every one hundred cases of treatment the proportion of proprietary Chinese medicines use increased from 32.8% to 37.9%, the proportion of the use of traditional Chinese medicine injection increased from 6.1% to 7.1%; every one hundred cases of treatment with hormone drugs increased from 24.5% to 20%. Commonly used antibacterial drugs in the amount and frequency of drug analysis Learn more about the new health care reform pilot units of township hospitals use of antimicrobial agents, the amount of sorting analysis, medication frequency analysis, of limited daily cost eight township health hospital in October 2009 and the use of antimicrobial agents in October 2010 varieties, the sales amount and frequency of drug for statistical analysis. The results showed that the antibiotics commonly used in the amount of medication in October 2009 the top five are: cefuroxime injection, cefoperazone (sulbactam sodium) injection, oral amoxicillin often release formulations, cefixime oral often release dosage form, ceftriaxone (sodium) injection; October 2010 the top five: cefuroxime injection, cefuroxime oral normal release formulations of oral amoxicillin and clavulanate potassium often release formulations, cefaclor constant release oral dosage form, levofloxacin injection. The average daily cost of treatment in October 2009 and October 2010, the top five antimicrobial agents: cefuroxime injection, oral cefaclor often release formulations, fosfomycin sodium for injection. From the the antimicrobial drugs DDDs results, in October 2009 antimicrobial drugs DDDs top five are: oral amoxicillin often release formulations, cefixime oral often release formulations, lincomycin injection, cephradine given oral often release formulations, azithromycin injection; antimicrobial drugs in October 2010 of DDDs top 5: Cefuroxime oral normal release formulations of oral amoxicillin and clavulanate potassium often release formulations, levofloxacin, cephradine oral often release formulations, oral amoxicillin often release formulations. The above results suggest that a the Feixi grassroots comprehensive reform of the health system paying off after the implementation of the drugs, \But survey results also showed that, Feixi County township hospitals irrational drug phenomenon is still more serious, mainly in the higher utilization of antimicrobial drugs and injections, the comprehensive reform of the primary health system should be further improved and strengthened.

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