摘要
目的了解云南省禄丰县乡、村两级医疗机构合作医疗实施后其处方用药的现状与存在问题，并提出促进合理用药的对策，进一步规范乡村医生用药行为。方法采用描述性统计分析方法和生物统计学分析方法。结果调查地区乡镇卫生院和村卫生室处方中，包含3～6种药品的比例分别为79．8％和76．9％，农村卫生室使用抗生素和激素的比例（分别为81％和32．5％）高于乡镇卫生院使用的比例（分别为77．3％和20．2％）。参加合作医疗病人门诊处方中含3～6种药品的比例均高于非参合病人，且其处方中药品费用和治疗总费用也高于非参合病人。结论乡村两级医疗机构的门诊处方中均存在一定程度的不合理、不安全用药现象，应通过规范供方服务行为和购药渠道和改革现行的村医报酬支付机制等措施，以改善乡村两级医疗机构不合理，不安全用药状况。
Objective To analysis the existing problems and current situation of the prescription of out-patients in township hospitals and village clinice affter carrying out CMS, then offer advices for the rational medication in order to further standard behavior of doctors at township and village level to ensure smooth development of new-type rural cooperative medical system. Methods Descriptive statistics analysis and biological staistics analysis were used. Results In the township hospitals and village clinics, the percent of the prescription that including 3 - 6 drugs was 79.8 % and 76.9 %, the percent of the prescriptions including antibiotics and hormone in the vilage clinics was higher than the township hospitals（ the percent of the prescriptions including antibiotics and hormone in the village clinics was 81% and 32.5% respectiveJy, and the percent in the township hospitals was 77.3 % and 20.2 % respectively）. The percent of the prescriptions that including 3 - 6 drugs in those patients who participant in CMS was higher than those patients who never participate, the medicine fees and total treatment fees in CMS was higher than that of non-CMS. Conclusion There are unreasonable and unsafe phenomenon in prescription at two level health institution to some extent. The possible reasons were analyzed and some mesures were adopted for standardization of the service behavior;the channel of purchasing medicines; the mechanism of rural doctors reward; medicine application status.
出处
《中国公共卫生》
CAS
CSCD
北大核心
2006年第10期1157-1158,共2页
Chinese Journal of Public Health
关键词
乡镇卫生院
农村卫生室
合作医疗
处方
township hospitals
village clinics
cooperative medicine system
prescription
