| Objective:To understand the real situation of village clinics implementation of national essential drugs zero rate sales system and compensation and to explore the effective path of village clinics implementation of basic drugs zero rate system and the compensation system.Methods:1.Literature review:Policy documents and stipulations of basic drugs zero rate system and Multi-channel compensation in Jiangxi and nation.Statistical reports of Jiangxi province.Periodical literatures and Government Reports about the institution.2.Field review: Take home survey of village doctors,fill in questionnaires at the same time.The household survey was carried out on the villagers,By asking different household site to fill out the questionnaire.3. Interview: Leaderships of the research field in city(county), town, village health system, Agriculture cure bureau leaders,Institutes of health director,village heads and 77 village doctors.Results:1.The provincial basic drugs zero rate system administrative villages coverage rate was 99.2%, outpatient service as a whole was 75.23% by the end of2013.Essential drugs actually enjoy a number of varieties to 46 kinds of less, up to520 kinds.Essential medicines were 50.00% distributed by pharmaceutical company.The rate of prescribing formal was 33.33%,percent of pass of prescriptionwas 44.44%.2.Implementation of essential medicine system of zero rate of village clinics was outpatient costs an average of 38.44 yuan;and the opposite village clinics was 49.83 yuan,villagers in implement counties think that the outpatient service charge level was lower than the opposite area(P=0.000).The 72.22% village doctors think village clinics benefit was decreased.3.The rate of essential drugs multi-channel compensation:Basic public healthservices in the post allowance 100.00%,epidemic prevention post allowance33.33%, Basic public health services 8.55% in the county of Wuyuan Not to implement the system;Village doctor pension allowance for living expanses100.00%,General fee 29.88%,Basic public health services 12.53%,Epidemic prevention post allowance 5.56% in Xiushui implement the system;LuXi county as a whole must be higher than that of wuyuan county and xiushui county,Basic public health services in the post allowance88.89%,Essential drugs zero rate of special subsidies 79.50%,Basic public health services 10.54%;The whole village doctors said multi-channel compensation level was low,80.52% of the village doctors think subsidy funds to grant in accordance with the evaluation criteria.4.In most of the village doctor’s income in 2013 was 3 ~ ten thousands yuan,Respectively 74.07% and 78.00% of the village doctors think that practicing revenue declined after implementation of the system in two present situation investigations.The 61.11% village doctors were not satisfied with income in Xiushui and Luxi country,55.56% in Wuyuan country,;Evaluation of old-age pension policy72.22% village doctors were not satisfied in Xiushui and Luxi country,88.89%in Wuyuan country,The villagers of village clinics implementing national essential drug system of zero rate of satisfaction as high as 90.91%.Conclusion:Since 2012 in the village clinic to carry out the state basic drugs zero rate system since the implementation effect was remarkable.The implementation of the system was reduced the medical burden of the villagers;Eased medicine for the medical status,The villagers satisfaction was higher;And the multi-channel compensation to some extent compensate for the village doctor’s income.The availability of essential medicines in village clinics was poor,Village doctor rational drug use safety needs to be improved.Multi-channel compensation fund issuance rate was on the low side,Village doctors’ reasonable income is difficult to guarantee, village doctors satisfaction were poor. |
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