Study On Evaluation Of Interventions To Improve Use Of Drugs In Areas Of Qianjiang

Object:More and more people pay attention to irrational use of drugs in rural areas. In order to eliminate it and reduce unnecessary waste of medicine resource, we have done many intervention researches. There are many effective interventions and useful experience. This study evaluated the effort of interventions in areas of Qianjiang, Chongqing, analyzed the strategies to cost containment of drugs, summed up and analyzed the theoretic basement,the condition ,environment and effort. This study provided some suggestions on how to improve rational use of drugs in rural areas and ensure the ration use of drugs (RUD) policy be effective in a sustainable way, analyzed the may factors, advised suggestions and conditions in order.Data and Methods Source, Content of Study, Analysis Methods:Literature review, field investigation, expert consultation and statistical method were used in this study. The data included: (1) literatures of rational use of drugs in home and abroad. (2) the data of areas of Qianjiang, Chongqing, including: documents, reports, the measures of drug use of health management department and health facilities; interview data of 99 person of areas and villages, including managers in health management department and health facilities and health workers; data of drug management in health facilities in rural townships; prescription data in health facilities, medical record of health facilities.This study content included: (1) theoretic study on ration use of drugs and cost containment of drugs, (2) study on strategies of inventions of RUD and cost containment of drugs in areas of Qianjiang, (3) evaluation of the effect of interventions in areas of Qianjiang, (4) study on the conditions and suggestions to apply interventions. Analysis methods are literature analysis, describing statistic, concluding statistic. Results and Conclusions:1. The result of literature reviewFirst, the strategies to improve use of drugs in rural areas of China are: the system management, dissemination and education, the mechanism of compensation, strengthen supervision, the containment of cost, the mechanism of inspiration, rules etc. Secondly, the strategies of containment of cost are: gross control, structure adjustment combining with the adjustment of price of medical treatment services; establish the aim manage system of the drugs income proportion of whole hospital and each section office; the reformation of personal system and inspiration system; strengthen the cost management and the account of cost of health facilities.2. The result of demonstrations:First, it summarized the main strategies of inventions in areas of Qianjiang. Implement the containment of cost mode. Establish many measures involved of the standardization of drugs purchase, use of essence drugs, and standardization of prescription, limit the units and expense of prescription. To assure the strategy of cost containment of drugs, the health facilities set down many systems such as personal admittance system, personal inspiration system, compensation system, check the prescription etc. The health management and CMS management department set down many CMS rules and systems such as declaring on the internet, the contract management, supervision at fixed time, to gave support and supervision from the exteriorly.Secondly, establish the mode of improving the use of drugs: the wings made up of the exterior strategies set down by the core department of health and CMS management and the inner strategies by the health facilities.Thirdly, sum up the feature of the inventions in areas of Qianjiang. Implemented the contract system; reduced the abduction services, controlled the cost of fee-for-service; the routine and institutional supervision and check system and comprehensive evaluation index impelled the health facilities and health workers to improving the level of health services and the use of drugs; improved the structure of the health facilities income, reformed the system of personal distribution, arranged the compensation system to a degree.Fourthly, in the evaluation of structure index, it received amendatory effect from the effect of the use and management of drugs in health facilities; it also received better effect on the process index evaluation form the mastery of knowledge of use of drugs, change of conception, the improving of behavior; in the evaluation of result index, got better result on the seven core prescription index, the after score exceed the years before the inventions, the score of invention group exceed the non-invention group also. Fifthly, the factors affected the effort of inventions in areas of Qianjiang were: the understanding and support of RUD by the health workers, the recognition and endorsement of health manager, the consummation of the systems of the health facilities, the supervision of health management department. The health management department, the CMS management department, health facilities, health workers and patients made effort by each in every tache of RUD.Discuss and Suggestions:The strategies of cost containment of drugs is consistent with polices of RUD in the fields of the aim and the choice of main body of inventions, they advance each other. It received the effect of improving the use of drugs on the evaluation of structure index, process index and result index. The factors affected the effort of inventions in areas of Qianjiang were: the understanding and support of RUD by the health workers, the recognition and endorsement of health manager, the consummation of the systems of the health facilities. The cost containment of drugs mainly by the strategy of cost containment of outpatient is suited to the villages and towns where use basic drugs to diagnosis and treat and with lower economy level. Suggestions: (1) Suggest the local government, the health management department and the CMS management department to give sufficient policy and fund support to local health facilities, exert its full capacity and effort. (2)Push the mode of cost containment of drugs by the strategies of cost containment of outpatient, the system of distribution, the combination of supervision in and out of the health facilities, the system of contract and the admittance of work force. (3)Build the system of evaluation index suited to the invention practice in the rural areas of our country.The innovation of this study is establishing the mode of improving the use of drugs: the wings made up of the exterior strategies set down by the core department of health and CMS management and the inner strategies by the health facilities; evaluating the inventions using the index systems make up of structure index, process index and result index; summing up the efficient inventions, put forward the main factors and applicable condition. The disadvantage of this study is short of the effort of cost containment by the RUD with the economical index.