Objective The Chengdu initiative essential medicine policy is part of the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development. We aimed to investigate the current situation of medicine use in rural hospitals and community health service centers, so as to provide evidence for policy-makers to select essential medicines and facilitate rational use of medicines.
Method We selected 7 township/community health institutions from which to collect medicine use information, including medicine category, number of medicine categories, cost and consumption. Descriptive analysis and the ABC classification method were applied for statistical analysis.
Results The number of medicine categories used in the community health institutions was four times greater than that in the township health institutions. Traditional Chinese medicine preparations accounted for 40% of the total medicine cost. Polypharmacy, overuse of injections, and improper use of antibiotics were major manifestations of the irrational use of medicines.
Conclusion The selection and use of essential medicines should be base on high quality evidence as well disease burden, the economic situation and specific demands in different areas. Drug and therapeutics committees should be set up to perform dynamic monitoring, education, evaluation and continual improvement of an essential medicines list.
Citation：
ZHOU Bangmin,WANG Li,LI Youping,YU Jiajie,YUAN Zhifang,TAN Peiyong,LI Xue,LI Honghao,JING Yuanyuan,MAO Xiu,MENG Yue,FANG Rui,YANG Xiaoyan,WEN Jin,LI Yuanyuan,YANG Wei,LIU Jun,CHEN Dongming,SHEN Zhonghua,ZHAO Ping,LI Zhujun,LI Fusen. An Investigation of Medicine Use in Rural Hospitals and Community Health Service Centers in Chengdu. Chinese Journal of Evidence-Based Medicine, 2008, 08(7): 529-537. doi: 10.7507/1672-2531.20080123
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- 1. 中华人民共和国卫生部信息中心. 中国卫生统计年鉴. 2003-2007.中华人民共和国卫生部网站. http://www.moh.gov.cn.
- 2. Manfred Huber, Ph D, Eva Orosz. Health expenditure trends in OECD countries. Health care financing review, 2003, 25(1): 1-22.
- 3. PATH, the World Health Organization, and the United Nations Population Fund. Essential Medicines for Reproductive Health: Guiding Principles for Their Inclusion on National Medicines Lists. Seattle: PATH; 2006.
- 4. 成都市卫生局. 成都市统筹城乡综合配套改革卫生专项工作方案. 2007.
- 5. 喻佳洁, 李幼平, 王莉, 等. 成都市乡镇和社区卫生服务机构基本医疗卫生服务状况调查--三圈七院六站预调查报告之一. 中国循证医学杂志, 2008, 8(4): 226-232.
- 6. 张崖冰, 胡善联. 限定日剂量在药物经济学研究中的应用. 卫生经济研究, 2001, 4: 12-17.
- 7. 敬媛媛, 李幼平,方锐, 等. 成都市乡镇/社区卫生服务机构人力资源配置现状调查--三圈七院六站预调查报告之二. 中国循证医学杂志, 2008, 8(6): 420-428.
- 8. 四川大学华西循证医学中心, 成都市基本药物目录及乡镇、社区医疗机构卫生人力资源预调查报告, 2007.
- 9. 成都市武侯区卫生局. 成都市武侯区社区卫生基本药物制度工作实施方案(暂订). 2007.
- 10. WHO Model lists of Essential Medicines(15 edition). Available from:URL:Http//www.who.int/medicines/publications/essential/medicines/en.
- 11. 国家基本药物2004版. Available from:URL:Http//www.sfda.org.cn.
- 12. 四川省城镇职工保险和工伤保险药物目录. Available from:URL:Http//www.molss.gov.cn/gb/zt/ypml/ypml.htm.
- 13. 吴蓬. 药品、药学与药师. 吴蓬主编. 药事管理学, 第3版. 北京: 人民卫生出版社, 2004. p18-19.
