Study Of Present Situation Of Rational Drug Use Based On National Essential Drug Policy In County Hospitals

Background:With the rapid development of social economy and pharmaceutical fields,The problem of drug use in Medical institutions is more and more serious, including"high expense and difficulty in medical care",drug-induced diseases and so on. As the important part in the three levels of medical network, Rational drug use in county hospitals is important to implement"National Essential Drug List"and to increase medical services.Because the short of relevant study information, research studies are very important.Object:1,Through the investigation and analysis of drug use in county hospitals on different economic development levels,we study present situation of drug utilization. 2,On the basis of national conditions and basic healthcare security institution in China at present, we analysis and summary the research indicators, evaluation criteria , influence factors and so on. To further improve the rational drug use system, the study provides policy and feasible proposals.Research data and methods:In accordance with economic development levels, four provinces were random chosen, including Shanghai, Shandong, Jiangxi and Ningxia. Every province was random chosen two county hospitals as the sample. Using"How to Investigate Drug Use in Health Facilities-Selected Indicators"and"How to Investigate Antimicrobial Drug Use in Hospitals-Selected Indicators",we study the drug use condition of 9600 outpatients,4800 inpatients and 400 doctors'awareness of the basic drug policy and its influence factors. Put the data in a database with FoxPro. Describe and analysis the rate or mean indicators about the drug use by using SPSS13.0.Results:1,The drug use condition of outpatients in county hospitals: Compared with the average of 3.88 kinds of medication varieties concluded by Zhang Xinping and so on, the indicator is less. But compared with 1.6～2.8 established by World Health Origination, the indicator is bigger. It show that effective of intervention measures which are used to improve the national drug use is not obvious; Compared with international standard 20.0%～26.8%,percentage of encounters with an antibiotic prescribed 49.19% is bigger. The difference of indicators in four provinces is statistical significance. It is connected to adopt measures of rational antimicrobial drug use; Percentage injections 48.26% is bigger than international standard 13.4%～24.1%; Percentage of drugs prescribed from essential drugs list 47.37% is smaller than 62.7%～63.55% in China in 2006.2,The antimicrobial drug use condition of inpatients in county hospitals: Compared with under 60% in"The Regulations On Hospital Infection Administration"established by China's Ministry of Health and 27%～63% established by WHO, Percentage of hospitalizations with one or more antimicrobials prescribed 80% is bigger; Average number of antimicrobials prescribed per hospitalization in which antimicrobials were prescribed 1.80.The regional difference of indicators in four provinces is statistical significance; Average duration of prescribed antimicrobial treatment 6.78 days is smaller than international standard 7～10 days; Percentage of antimicrobial prophylaxis prescribed for surgical inpatients who received prophylaxis 77.75% is bigger than the report of foreign literature 30%～40%; Average duration of hospital stay of patients who receive antimicrobials 9.42 days, including 10.25 days in Shanghai province.Number of antimicrobial drug sensitivity tests reported per hospital admission is 15.67% in Shanghai province,1.08% in Jiangxi province and 0 in Ningxia province.This result is far below the 50% established by China's Ministry of Health.3,Doctors'awareness of the basic drug policy and its influence factors: Doctors'awareness of the basic drug policy is not optimistic. Most of the doctors only partly understand or even don't know at all.Using multiple linear regression,Study the influential factors of behavior and three arguments enter the final model finally. The number of training courses about the knowledge of rational drug use and knowing all about national essential drug policy have a positive impact on the percentage of drugs prescribed from essential drugs list, while Average number of outpatients diagnosised by every doctor every day have a negative impact.Conclusion:By analysising the result of the survey, the situation of rational drug use by outpatients and inpatients in country hospitals is still not optimistic. It mainly reflected in abuse of injection and antimicrobial drugs, lower percentage of drugs prescribed from essential drugs list, doctors'low awareness of the basic drug policy and so on. It has a long way to achieve the goal of rational drug use in medical institutions gradually.