Evaluation On The Status Of National Essential Drug System In Pilot Township Hospitals Of Chenzhou City In Hunan Province

OBJECTIVES:To describe the pilot effectiveness of national essential drug system in pilot township hospitals of Chenzhou city in Hunan Province, and to analyze determinants of the satisfaction for the national essential drug system.METHODS:Using cluster sampling method,6township hospitals in Beihu and Suxian district in Chenzhou city of Hunan province were randomly selected. EPIDATA3.02and EXCEL form were used to develop the dataset, and data analysis was performed by SPSS-version16.0, the reliability coefficient Cronbach’s a was calculated to analyze the internal consistency of the satisfaction questionnaire with the recognition, accessible, acquirable dimension, categorical data were described with frequency and proportion, the mean, standard deviation and95%confidence interval of each dimension of satisfaction were calculated. The mean differences between groups were analyzed by t test or ANOVA, and the satisfaction rate were calculated and compared among the groups by Chi-squire test. The proportion of the kinds of the essential drug of prescriptions account for the total kinds of the drug prescribed during a month was calculated. All hypothesis test were two sides and the significance was a=0.05.RESULTS:Cronbach’s a of doctors’satisfaction questionnaire was 0.79, and the patients’satisfaction questionnaire was0.45. The mean of doctors’ satisfaction was20.02, the standard deviation was3.26, there are40.3%doctors were satisfied with the national essential drug system,85.2%doctors reported that their incomes were reduced,66.4%doctors thought that the essential drugs did not meet the demands of treating common diseases,79.9%doctors reported that the categories of essential drugs were incomplete. Univariate analysis showed that the working years(P=0.009)and the medical education level(P=0.000)were the main determinants of satisfaction for doctors, and the multivariate analysis showed that the medical education level (P=0.014) was the main determinant of satisfaction. The mean of patients’ satisfaction is16.86, the standard deviation was7.37. There are50%patients were satisfied with the essential drug system,53.7%patients didn’t know the essential drug system at all, patients are satisfied with the curative effects of the essential drugs(same as other drugs42.7%), the quality(good59.1%) and the price (appropriate54.5%).In addition, they were dissatisfied with the zero profit selling system (satisfied32.7%). Univariate analysis showed that the working status (P=0.000) and the recognition for essential drugs system (P=0.000) were the main determinants of satisfaction, and the multivariate analysis showed that the education level(P=0.006), rationality of medical cost(P=0.004) and trustful doctors(P=0.011) were the independent determinants of satisfaction. The mean of total drug amount of prescription was4.14, and the essential drug was3.56. The percentage of the essential drug was86%.CONCLUTIONS:The percentage of prescription drug accounting for the essential drug was86%;40.3%doctors are satisfied with the essential drug system; Doctors with master degree and medical specialty education level are more satisfaction;50%patients are satisfied with the essential drug system, patients with high school education level, rationality of medical cost and trustful doctors are more satisfaction.