CAJ | 학술논문

目的：了解我国基层医务人员对基本药物制度实施效果的认知评价情况及满意度情况。方法采用随机抽样方法，于2013年7月对浙江省绍兴市、丽水市，江西省南昌市、九江市，陕西省西安市、安康市和新疆维吾尔自治区乌鲁木齐市42所基层医疗机构，共计791名基层医务人员，采用自行设计的问卷进行调查，调查主要内容为基本药物制度在基层卫生服务机构实施情况及存在的问题，收回有效问卷782份，有效回收率为98.86％。结果不同地区医务人员对基本药物制度实施后的门诊工作量变化情况、转诊患者数变化情况、医务人员收入变化情况、医务人员工作积极性变化情况、患者对医生的信任度、促进医生合理用药、价格合理性、种类能否满足需求、使用疗效、配送效率、患者认可度、是否利于“小病到基层”、能否促进基层医疗机构发展的评价比较，差异均有统计学意义（P﹤0.05）。医务人员对基本药物制度实施效果的总体满意率达到88.2％（690/782）。对基本药物制度实施效果非常满意的医务人员有5.9％（46/782）；比较满意的有34.5％（270/782）；一般满意的有47.8％（374/782）；不太满意的有10.4％（81/782）；非常不满意的有1.4％（11/782）。不同地区、年龄及年收入的医务人员对基本药物制度实施效果的满意度比较，差异有统计学意义（ P﹤0.05）。结论所调查基层医务人员对基本药物制度实施效果认知评价不同地区之间是有差别的；对基本药物制度实施效果总体满意度较高。
목적：료해아국기층의무인원대기본약물제도실시효과적인지평개정황급만의도정황。방법채용수궤추양방법，우2013년7월대절강성소흥시、려수시，강서성남창시、구강시，합서성서안시、안강시화신강유오이자치구오로목제시42소기층의료궤구，공계791명기층의무인원，채용자행설계적문권진행조사，조사주요내용위기본약물제도재기층위생복무궤구실시정황급존재적문제，수회유효문권782빈，유효회수솔위98.86％。결과불동지구의무인원대기본약물제도실시후적문진공작량변화정황、전진환자수변화정황、의무인원수입변화정황、의무인원공작적겁성변화정황、환자대의생적신임도、촉진의생합리용약、개격합이성、충류능부만족수구、사용료효、배송효솔、환자인가도、시부리우“소병도기층”、능부촉진기층의료궤구발전적평개비교，차이균유통계학의의（P﹤0.05）。의무인원대기본약물제도실시효과적총체만의솔체도88.2％（690/782）。대기본약물제도실시효과비상만의적의무인원유5.9％（46/782）；비교만의적유34.5％（270/782）；일반만의적유47.8％（374/782）；불태만의적유10.4％（81/782）；비상불만의적유1.4％（11/782）。불동지구、년령급년수입적의무인원대기본약물제도실시효과적만의도비교，차이유통계학의의（ P﹤0.05）。결론소조사기층의무인원대기본약물제도실시효과인지평개불동지구지간시유차별적；대기본약물제도실시효과총체만의도교고。
Objective To investigate the cognitive appraisal and satisfaction survey on the implementation effect of essential medicine system among staffs in primary care medical settings. Methods Using random sampling method,we enrolled 791 staffs in 42 primary care medical settings in Shaoxing and Lishui in Zhejiang Province,Nanchang and Jiujiang in Jiangxi Province,Xi'an and Ankang in Shannxi Province and Urumqi in Xinjiang Uygur autonomous region. We conducted survey by using self-designed questionnaire,and the survey content included the implementation status and current problems of essential medicine system in primary care medical settings. A total of 782 effective questionnaires were returned with an effective returning rate of 98. 86%. Results Medical staffs from different regions were statistically different(P﹤0. 05)in the evaluation of the changes in outpatient service volume, the number of referral patients, the income of medical staffs, the work motivation of medical staffs, the trust of patients towards doctors, the facilitation of rational drug administration, the rationality of cost, whether the drug categories could satisfy demands, using efficacy, delivery efficiency, the recognition degree of patients, whether the treatment of minor disease is benefited and whether the development of primary care settings is promoted after the implementation of essential medicine system. The overall satisfaction rate of medical staffs toward basic medical system reached 88. 2%(690/782). The medical staffs who were very satisfied with the implementation effect accounted for 5. 9%(46/782), and the rates for being satisfied,barely satisfied and dissatisfied were 34. 5%(270/782),47. 8%(374/782)and 10. 4%(81/782)respectively;the rate for being very dissatisfied was 1. 4%(11/782). The influence of regions,ages,and income levels on the satisfaction degree was statistically significant(P﹤0. 05). Conclusion The cognitive appraisal on the implement effect of essential drug system among staffs in primary care medical settings varies with different provinces. The overall satisfaction degree with the implementation effect of essential drug system is high.