Study On The Evaluation Of The Essential Medicine System In Village Clinics

Objective:To understand the knowledge and attitude of the national essential medicine system,the evaluation of essential medicine policy's implementation and satisfaction,to analyze the influence factors of the evaluation,and to provide feasible suggestions to promote the essential medicine system in the smooth implementation in village clinics.Methods: In this study,the village doctors of Zhejiang,Hubei and Gansu provinces in the middle of the five counties and cities in a total of 19 townships were taken to carry out a questionnaire survey,and the village doctors and relevant department's heads for interviews.The data were analyzed by Epidata3.0,EXCEL and SPSS19.0,including descriptive analysis and Logistic regression analysis.Quantitative data were expressed as mean number,classification rate and composition ratio.Results :(1)Village doctor's team was currently mostly male,and more concentrated in the age of 40 to 60 years old,professional qualifications for secondary school,got village doctor qualification accounted for 80.6%,monthly wage income level of RMB1838.(2)The awareness rate of essential medical policy for village doctors was 97.6%,including these three aspects of the 2012 edition of the National Essential Medicines List(63.5%),the National Guidelines for Clinical Application of Essential Medicines(44.3%),the National Essential Drugs Formulary(39.4%).(3)94.3% of the village doctors received essential medicine training,and more to lectures,meetings and online training.(4)62.1% of the village doctors believed that the implementation of the essential medicine system was necessary or very necessary,but for the essential medicine system content recognition was only 43.1%,the reasons for disagree with the essential medicine system,the top three were "shortages of required drugs"(67.1%),"limited physician medication"(62.5%)and "high delivery price"(46.9%).(5)For the essential medicine list,only 11.8% of the village doctors believed that it coould meet the needs.Children's medication,dermatology drugs and gynecological drugs were considered to be the top three drugs to be supplemented,accounting for 81.0%,60.1%,and 59.9%.(6)44.1% of the village doctors held a general attitude with the pharmaceutical distribution agency selected by the government,98.8% of the village doctors believed that there was a shortage of essential medicine delivery,and the lack of commonly used drugs,more than 50% thought there was a problem with the timing of the delivery of essential medicines,and 71.1% of the village doctors said the distribution price was high.(7)54.7% of the village doctors believed that the implementation of the essential medicine system to reduce the burden of farmers in general,and 75.1% of village doctors believed that the system caused the decline of institution's income.(8)In general,28.4% of the village doctors were satisfied with the essential medicine system;the overall score of satisfaction was 53.3 points,in the "general" level.(9)Multivariate regression results showed that whether the list of essential medicines to meet the needs of the villagers' chronic disease medication,reduce the burden of villagers' drug use,government subsidies,residents' propaganda,the quality and distribution price were the main factors affecting the satisfaction of the village doctors.Conclusions:The overall level of village doctors in China was not high.There were problems with a high age,low academic qualifications,and weak professional ability and so on.The village doctors generally believed that it was necessary to implement the essential medicine system in the village clinics,but the evaluation of the essential medicine list,the directory,the price and other aspects was not high;the overall satisfaction of the essential medicine system was in general.The content,quality and distribution prices of essential medicines,the degree of burden on villagers' use of medicines,government subsidies,and residents' propaganda had affected their overall satisfaction with the essential medicine system.Therefore,the government urgently needs to take measures to improve the timely update of essential medicines list,reasonable pricing,timely distribution,to ensure that the relevant compensation policy in place,at the same time,to improve the treatment of village doctors to carry out vocational education,stabilize the team of village doctors.