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初步建立国家基本药物制度是2009年1月国务院会议通过的新医改方案中医疗卫生体制改革的一项重要改革。本文通过对南京市社区卫生机构实行基本药物零差率的具体做法进行调查,发现实施过程中存在药品配送无法到位、“零差率”药品收入占药品总收入比例低、药品收入占总收入比重仍然较大等问题。进行分析后提出对现有配送体制改革以保证“零差率”基本药物的正常运行;社区卫生机构应加强收支两条线预算管理,规范医生用药行为来提高“零差率”药品的使用比例;逐步加大零差率药品品种,最终实现全部使用;相关部门应进一步加强宣传,营造社区卫生机构实施基本药物“零差率”的良好氛围等建议建立完善国家基本药物制度。
The initial establishment of the national essential drug system is an important reform of the medical and health system reform in the new medical reform plan passed by the State Council in January 2009. Through the investigation of the specific practices of zero rate of essential drugs in community health institutions in Nanjing City, this paper finds that the distribution of medicines in the implementation process can not be put in place. The ratio of “zero-slip rate” to the total income of medicines is low, The proportion of income is still large and other issues. After the analysis, we proposed the reform of the existing distribution system so as to ensure the normal operation of the essential drugs with “Zero Difference Rate”. The community health institutions should strengthen budgetary management on the two lines of revenue and expenditure, “The proportion of drug use; Gradually increase the zero-defect rate of drug varieties, and ultimately achieve full use; Relevant departments should further strengthen publicity, and create a community health institutions to implement the basic drugs ” Zero-slip rate "good atmosphere, etc. Suggestions to establish and improve the national basic Drug system.