Study On Current Status Of Establishment & Usage For The Essential Drug List Of New Rural Cooperative Medical System

ObjectThe Essential Drug List(EDL) of New Rural Cooperative Medical System(NCMS) is the reimbursement list of NCMS, it is one of the important measures which can control the unreasonable increase of medical fee, promote rational drug use, ensure the sustainable development of NCMS, This article investigates and analyzes the EDL of NCMS in national various provinces, the EDL of NCMS and the status of drugs'usage of discharged patients in investigated areas, related usage strategy of the EDL everywhere to understand the present situation of formulation and usage of the The EDL of NCMS, analyze the question and the insufficiency, these can consummate the formulation and usage of the EDL of NCMS, promote the sustainable development of NCMS.MethodsThis article adopts the quantitative study and qualitative study methods.1. Material Collection Ways:acquire the domestic and foreign EDL policies and the current status of usage.2. Questionnaire Letter Survey Law: analyze the status of the formulation, the use and the managemen of the EDL of NCMS and the suggestions and expections for the present list in 31 provinces.3. Typical Survey Procedure: samples 4 counties In Hubei and Chongqing, uses the descriptive analysis and interview to investigate and study the formulation of the EDL of NCMS,the status of drugs'usage and intentions of all parties.4. Statistical Analysis Method: Using descriptive analysis,rank sum test to analyze the difference between the formulation the EDL of NCMS and the list of everywhere.5. Utilizes the fair theory, the health management theory, the development theory, the medicine economic, the induction, the deductive method to carry on the correlative theoretical demonstration.6. The Experts Proves The Law: Consults the domestic pharmacy experts and the health management experts to argue the entire research design and consults them to gather the suggestions for the formulation, usage and implement of the EDL of NCMS.Results and Conclusions1. The formulation status of EDL of NCMS(1)We don't have a unified formulation standard of EDL of NCMS, the structure and drug category of EDL have big different from each province, the scope of drug categories from 411 to 2277.(2)Each province refer to the Nation essential drug list and their situation to formulate the drug list, although the all drug of Nation essential drug list in edition of the year of 2004 are selected by different province, twenty provinces together select 74 categories, account for 9.95% of National EDL.(3)the formulation of EDL of NCMS is non-standard and irrationality structure: non-standard of drug name, un-unified western drug category, no-separated edition of western and Chinese drug, no common name, no dosage form, 50% provinces have no notice and etc.2.Spot investigation of the EDL of NCMS and its drug use status on the two level of county, township Medical organizations.(1)the categories and quantities of drug use of the same medical organization have a big different, such as the categories of drug use in the medical organization of county from 119 to 661.(2)the categories and quantities of drug use less than 90 categories by accumulative accounting for the 80% of frequencies or drug fee.(3)the categories of drug use belong to the EDL account for the total categories of drug use range from 23.33% to 94.07%.(4)the utilization rate of drug use of EDL, such as the utilization rate of the western drug range from 25.40% to 61.80%,Chinese medicines range from 6.64% to 36.51% in county medical organizations.(5)serious drug use phenomenon such as incline to use high-price antibiotics, commonly phenomenon of using two and more categories of antibiotic.Suggestion1. We should formulate the EDL of NCMS by reasonable and scientific methods.(1)The EDL of NCMS is a reimbursement table of content to NCMS, we should concern the basic principles such as'clinic needs, safe and effective, reasonable price, easy to use, assured the supply, controllable quality'to make the formulation, simultaneously, keep consistent with National Essential Drug List and combine with the character of rural drug use to choose basic drug.(2)we should formulate the criterion and the standard of EDL of NCMS from the central government, formulate the provincial EDL of NCMS from the provincial government which allow the basis organization to adjust the EDL of NCMS according their actual situation.(3)The EDL of NCMS should be managed by the level of different medical organization, and manage the drug by class a and b.(4)we should mainly emphasis the selection upon the antibiotic class drugs and traditional Chinese medicines.(5)we should regulate the structure of EDL of NCMS and its Written form and expression.2. Improving the assorted policies, advancing the rational drug use(1)we should establish the systems of supervisor,monitor, assessment.(2)Enhancing the regulation and control of medical organizations to advance rational drug use.(3)developing the propaganda and education of EDL to promote level of recognition of related parties.