Effects of China's national essential medicines policy on the use of injection in primary health facilities
Effects of China's national essential medicines policy on the use of injection in primary health facilities
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DOI：
10.1007/s11596-012-1008-4
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发表时间：
2012-08-01
影响因子：
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通讯作者：
Zhang, Xinping
中科院分区：
文献类型：
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作者：
Xiang, Xiaoxi;Yang, Chunyan;Zhang, Xinping
我国自经济改革以来，注射剂的过度使用已经存在了20多年。在新的卫生改革时期，这是一个老大难问题，也是一个新的挑战。本研究旨在通过调查中国基层医疗机构的处方信息，评估国家基本药物政策（NEMP）对注射剂使用的影响。2010年和2011年1月至9月，设计并分发了调查表，以收集6个省120个初级保健设施注射使用情况的经验数据。注射使用被测量为具有一次或多次注射的处方的百分比的指标。结果显示，在NEMP改革期间，各调查区处方中注射剂的比例从38.91%下降到36.82%（χ 2 =11.158，P=0.001）。东、中、西部地区2011年注射剂使用水平差异有统计学意义（χ 2 =223.584，P=0.000），西部地区注射剂使用水平最低（27.73%），中部地区注射剂使用水平最高（43.10%）。2011年各省份注射剂使用水平也存在较大差异（26.00%~ 58.25%，变幅32.25%）。2011年注射剂使用水平仍远高于WHO建议的发展中国家标准（13.4%-24.1%）。结果表明，NEMP改善了我国注射剂的使用，但注射剂滥用情况依然严重，促进合理用药尤其是注射剂的合理使用是下一阶段NEMP工作的重点之一。
The overuse of injection exists more than 20 years since economic reform in China. It is a persistent problem and seems becoming a new challenge in the new health reform period. This study was designed to assess the effect of national essential medicines policy (NEMP) on injection use at primary health facilities in China by investigating their prescription information. Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011. The injection use was measured as the indicator as the percentage of prescriptions with one or more injections. The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82% (chi (2)=11.158, P=0.001) in the all survey areas during the NEMP reform. The difference in level of the injection use in 2011 was significant among the eastern, central and western regions (chi (2)=223.584, P=0.000); level of the injection use in western region was the lowest (27.73%), while that in the central region was the highest (43.10%). The level of the injection use in 2011 among different provinces was also of great difference (26.00%-58.25%, range: 32.25%). The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries (13.4%-24.1%). It was concluded that NEMP has improved injection use in China, but the injection abuse situation remains serious, indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs, especially the injection use.