Quantitative Study Of Pharmaceutical Care In Health Facilities In China

Objective:To summarize and quantitative analysis present pharmaceutical care in health facilities in China and probe influencing factor, meanwhile refer the experiences of pharmaceutical care in other countries to seek controllable main intervention spot and feasible intervention strategy in order to promote level of pharmaceutical care in health facilities in China at the present stage and condition, and to provide knowledge base to standard guide and appraisal indicators system of pharmaceutical care in health facilities in China formulated by medical administrative department.Methods:This paper uses many research methods synthetically, including:(1) Literature research. To unscrambling, analyze and compare pertinent literature from library,Internet, periodical, journal, Medline and find out some document beneficial to the development of pharmaceutical care in health facilities in China.(2) Expert consulation. Research design and investigation instrument was proofed by experts in order to ensure the science and feasibility of research project. (3) Field investigation. Field investigates the sample health facilities in the east, middle and west of China, the content include pharmaceutical care in out-patient clinic and pharmacy. (4) Group discussion. Constructing several special subject groups to thorough free discuss generally, analyze and summarize the problems on pharmaceutical care. Every group include total 6-12 members from patient, medical personnel,expert and relate administrator.(5) Statistics method. Data is recorded by Epidata 3.1 and analyzed by SPSS 15.0 via descriptive statistical methods, t test, rank sum test, chi-square test, Dunnett's T3 multiple comparison and multiple linear regression model.Results:(1)Theory researchPharmaceutical care have deep quality theory connotation,which emerge from management theory of medical quality of service. Now there has been extensive pharmaceutical care practice in WHO and developed nation. This paper refers to these theories and practice and design the representative pharmaceutical care evaluation indicators system, such as consultation time, dispensing time etc.(2) Practice researchAdopt above these design indicators to evaluate pharmaceutical care in out-patient clinic and pharmacy in health facilities in China, main result as follow:1)The difference of average consultation time in health facilities between the east, middle and west of China was significant. According to separate criteria of average consultation time established by Vania dos Santos, The average consultation time in health facilities in China (382.46 seconds), which was correspond to other countries, should been sorted as normal. There were a lot of research values about the average consultation time in other countries, which was uneven and great different between them.2)The ratio of outpatient's prescription drug in hospital and community health facilities were 89.8% and 11.7% respectively, The ratio of outpatient's drug expectation were 76.4% and 75.4%. The ratio of prescription doctors influenced by outpatient's drug expectation in hospital and community health facilities were 92.3% and 83.1% respectively. outpatient's drug expectation and doctor'perception to outpatient's drug expectation would take great effect on prescription and effect strength of the latter was greater.3) The average dispensing time in pharmacy in hospital and community health facilities in China were 77.92 seconds and 85.66 seconds respectively,which were correspond to other countries. The difference of average dispensing time between other countries was great. Average number of drugs per encounter in pharmacy in hospital and community health facilities in China were 4.16 and 4.00 respectively, which were bigger than those in other countries. Percentage of drugs actually dispensed in pharmacies in all health facilitiess in China were much more than 98%, which was better than those in other countries.4) The percentage of drugs labelled by patient name and percentage of drugs labelled by correct time were 62.91% and 61.84% respectively in pharmacy in large scale hospital in China. The percentage of drugs labelled by patient name and percentage of drugs labelled by correct time were 60.12% and 43.47% respectively in pharmacy in community health facilities in China. The research values above were correspond to the percentage of drugs adequately labelled in other countries. The percentage of drugs prescribed by generic name were 40.58% and 30.90% in pharmacy in hospital and community health facilities in China respectively, which were low. The difference of percentage of drugs prescribed by generic name were uneven and big between pharmacy in health facilities in other countries.5) The percentage of drugs use completely informed by pharmacy in hospital and community health facilities in China were 31.90% and 56.03% respectively, the latter was better. The percentage of patients'knowledge of drugs use completely in pharmacy in hospital and community health facilities in China were 71.04% and 66.57% respectively, which were good and correspond to those in other countries.Conclusion:(1) Consultation time was short and significant different between the east, middle and west of China. It was necessary to adopt some measures such as reduce doctor's work load to extend consultation time in China. It was reasonable for doctor to communicate fully with outpatients and perceived their drug expectation correctly in order to raise level of prescription rational use in clinic service.(2) It was necessary to formulate the standard guide of pharmaceutical care in health facilities as soon as possible and enforce the diversity service; It was reasonable to enact the "drug use practice" including supervising system, staff training, hardware construction, purchase and proving, conservation, utilization and service. The "drug use practice" would make the drug use to be controlled according to law and then raise the science of administration.(3) We can strengthen the internal management in the hospital by lead, pharmaceutical care mechanism and persistent action in order to promote the implement of pharmaceutical care norm.Innovations:(1)This paper research from the connotation of pharmaceutical care quality theory and refers to extensive pharmaceutical care practice in WHO and developed nation,and then tentative design the representative pharmaceutical care evaluation indicators system, such as consultation time, dispensing time etc.(2)Quantitative practice study mainly. Adopting the design indicators to quantitative allround study the pharmaceutical care in out-patient clinic and pharmacy in health facilities in China, which provide some base to construct standard guide of pharmaceutical care in health facilities in China and to consummate pharmaceutical care quality appraisal indicator system.