文章摘要
史 航,王 莹,刘平羽,孙新华,李 歆.启东市农村老年患者基层医疗机构基本药物全额保障政策的效果评价[J].南京医科大学学报(社会科学版),2020,(3):215~219
启东市农村老年患者基层医疗机构基本药物全额保障政策的效果评价
The effect evaluation of the full coverage policy of essential medicines for rural elderly patients in primary health care institutions in Qidong
投稿时间:2019-10-08  
DOI:10.7655/NYDXBSS20200303
中文关键词: 全额保障  基本药物  实施效果  政策评价
英文关键词: full coverage  essential medicine  implementation effect  policy evaluation
基金项目:江苏省教育厅高校哲学社会科学基金“不同所有制下江苏基层医疗机构实施基本药物制度的效果比较评价及政策完善研究”(2017SJB0277)
作者单位
史 航 南京医科大学医政学院江苏 南京 211166 
王 莹 南京医科大学医政学院江苏 南京 211166 
刘平羽 南京医科大学第二附属医院药学部江苏 南京 210011 
孙新华 启东市卫健委医政处江苏 启东 226200 
李 歆 南京医科大学医政学院江苏 南京 211166
南京医科大学药学院全球健康中心江苏 南京 211166 
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中文摘要:
      文章基于启东市参加基本医疗保险的70岁以上老年患者就诊数据,定量分析基本药物全额保障政策实施前后诊疗指标的变化,并对关键知情人开展定性访谈,以评价启东市农村老年患者基层医疗机构基本药物全额保障政策的实施效果,提出政策优化建议。结果显示,政策实施以后,受益人群平均每月出院人次增加478人次(P=0.001),次均新农合医保补偿上升472.52元(P<0.001),次均自付费用下降430.35元(P<0.001),次均自付比例下降14.8%(P<0.001),次均住院费用上升31.18元(P<0.001)。访谈结果也表明,该政策减轻了老年患者的就医负担,提高了老年患者的住院卫生服务利用。为保证政策获得更好的实施效果,建议循序渐进地实施老年患者基本药物全额保障政策,加强配套措施的实施,杜绝浪费现象,并设立单独筹资渠道筹集资金。
英文摘要:
      By evaluating the implementation effect of the full coverage policy of essential medicines for rural elderly patients in primary health care institutions in Qidong, this paper puts forward some suggestions for policy optimization. Based on the medical data of elderly patients over 70 years old who participated in basic medical insurance in Qidong, this paper quantitatively analyzed the changes of diagnosis and treatment indicators before and after the implementation of the full coverage policy of essential medicines, and conducted qualitative interviews with key insiders. The results showed that, after the implementation of the policy, the average monthly discharge of the beneficiary population increased by 478(P=0.001), the average NCMS medical insurance compensation increased by 472.52 yuan(P<0.001), the average out?of?pocket expenses decreased by 430.35 yuan(P<0.001), the proportion of patients per time out?of?pocket decreased by 14.8%(P<0.001), and the average hospitalization expenses increased by 31.18 yuan(P<0.001). The interview results also showed that the policy had reduced the burden of seeking medical treatment for elderly patients and improved the utilization of inpatient health services for elderly patients. In order to ensure a better implementation effect of the policy, it is suggested that the implementation of the full coverage policy of essential medicines for rural elderly patients in primary health care institutions should be promoted step by step, the implementation of supporting measures should be strengthened, waste should be avoided, and a separate fund?raising channel needs to beset up.
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