全额保障老年患者在基层公平享有合理使用基本药物政策研究

目的:为实施全额保障老年患者在基层公平享有、合理使用基本药物费用政策提供可行的管理策略。方法:以南京市江宁区参加职工医保的65岁以上老年患者就诊的数据为来源,分析其基本药物使用的状况和主要疾病病种的构成。结果:老年患者主要以抗微生物药、调节水、电解质及酸碱平衡药、内科用药(中成药)和心血管系统用药为主;主要是心脑血管疾病、呼吸系统疾病、消化系统疾病以及损伤骨折等;用药经济负担较重。结论:应加强老年人常用基本药物的配备,提高可获得性;实施分类管控,最大程度地减轻使用基本药物的经济负担;规范医师用药行为,提高基层医疗机构合理用药的水平;加强用药知识宣教,发挥社区药学服务的作用。

Policy investigation of guaranteeing elderly patients with basic drugs in grassroots platform

Objective: To fully guarantee elderly patients with fair and reasonable basic drug use, and to provide feasible management strategy. Methods: We selected the data of elderly patients who were over the age of 65 and participated in worker health in Jiangning district of Nanjing to analyze the situation of basic drug use and the composition of main disease. Results: The elderly patients mainly used antimicrobial drugs, regulating water, electrolyte and acid-base balance drugs, internal drugs (Chinese patent medicine) and cardiovascular system drugs. The main diseases of elderly patients were cardiovascular and cerebrovascular diseases, respiratory disease, digestive system diseases and fracture damage, and etc. The economic burden of them was heavy. Conclusion: We should increase the basic drug stockpiles and improve their availability for the elderly patients, and minimize the economic burden of essential drugs by using classified control. Medical behavior of physician should be standardized, and the level of rational drug use of basic-level medical institutions should be improved. Meanwhile, we should strengthen the spread and education of medical knowledge, as well as highlight the effect of community pharmaceutical care.