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目的:分析基本药物制度的政策效应及存在的问题,提出相应的对策建议,为政策可持续发展提供参考。方法:依据新医改、基本药物制度的政策要求和住院患者的政策效应感知进行定性定量分析。结果:在提高基本医疗服务基层可获得性、改善药物使用合理性方面政策效应明显,降低医药费用负担的效应有限;实施中存在患者就诊和住院向上一级医疗机构反流的倾向,基层医疗机构滥用输液治疗加重的问题。结论:通过提高基层医疗机构的服务能力,调整医疗保险报销机制,引导患者流向基层医疗机构,降低医药负担;加强医患沟通与合作,提高用药合理性。
OBJECTIVE: To analyze the policy effect and existing problems of the basic drug system, put forward the corresponding countermeasures and suggestions, and provide a reference for the sustainable development of the policy. Methods: According to the new medical reform, the policy requirements of the essential drug system and the perception of policy effect of inpatients to carry out qualitative and quantitative analysis. Results: The policy effects were obvious in improving grassroots availability of basic medical services and improving the rationality of drug use, and the effect of reducing the burden of medical expenses was limited. In the implementation, there was a tendency of patient visits and hospitalization to go back to higher level medical institutions. Abuse of infusion therapy aggravating problems. Conclusion: By improving the service ability of grassroots medical institutions, we can adjust the medical insurance reimbursement mechanism and guide the patients to flow to the primary medical institutions to reduce the medical burden. The communication and cooperation between doctors and patients should be strengthened to improve the rationality of medication.