Research On The Condition And Influential Factors Of The Prescribing In Beijing Community Health Service Centers

Objectives:The study is focused on comprehensively understanding the prescriptions of community health service centers in Beijing by the year of2009to2010and giving a full discussion of the factors affecting prescriptions, in order to find the key issues of drug use and management in community health services agenciesa and provide suggestions on the application and management of medicines.Contents:The evaluation indicators and the major influential factors of prescribing were detemined. Then the status of prescribing in Beijing was analyzed by considering the Rationality of Prescription, the use of national essential drugs and prescription drug expenses. What’s more, this paper was analyzed the factors affecting the prescription rationality in community health service center in Beijing. At last, suggestions were provided on management and applications on medicines in community health service centers in Beijing.Methods:The study was collected the relevant policy documents, research reports, papers and other information of the prescription medication. With the Prescription drug data based on field survey and the data of the State Council Medical Reform Office, descriptive analysis, one way anova and hierarchical cluster analysis were used to analyze the condition of community health service centers and logistic regression analysis analyzed the factors influencing the rationality of the prescription.Results:Eight evaluation indicators of prescription reasonable, the national essential drug use condition and drug costs in three dimensions were chosen, and cleared the key influencing factors which influencing the community outpatient prescription reasonableness, by studying the indicators and factors of prescription in the literature. Compared with relevant results, the average drug number of each prescription as well as the usage condition of antimicrobial drugs, hormones, injection was reasonable in2009-2010. National essential drug sales accounted for only23.47%, and prescription drug expenses reached106.79yuan in2010.The rationality of prescription of community health service centers held by government, medical institutions and other subjects were all in line with WHO standards. Government-run medical institutions was better than other types of organizations on using the national essential drugs and the cost of prescription drugs of government-run community institutions was lower than which of the community health service centers organized by medical institutions and other subjects.The average drug number of each prescription in all of the district (county) were in line with WHO standards, but in some districts (counties) the antimicrobial drug prescription rates and injection prescription rate didn’t meet WHO’s criteria; the national essential drug use rate in most of the district (county) was between60-80%, the accounted for the national essential drug sales was mainly in the range of40-60%; average prescription drug costs in half of the district (county) was more than100yuan.The districts (counties) were divided into four typeset, the first one included Dongcheng, Xicheng, Chaoyang, Fengtai, Haidian, and Shijingshan; the second included Mentougou, Daxing and Changping; the third one include Fangshan County and Miyun County; the fourth included Shunyi, Tongzhou, Pinggu, Huairou and Yanqing. There were obvious statistical differences in prescriptions in these areas.Analyzed the rationality of prescriptions, the mainly influential factors included areas, holders of the communication health service centers, the method of the two lines of revenue and expenditure management and percentage of general practitioners.Conclusions:First, the prescribing of Beijing community health service centers is totally rational, however, a small amount of single prescription’s drug number does not meet the state regulations. Tthere are potential improvements to the national essential medicines and need to be measures to reduce the expense of the relatively expensive prescription drugs. Secondly, there are obvious difference in prescriptions between community health service centers held by different subjects, The government-run community health service centers is better than the non-governmental agencies. Thirdly, the development of prescribing is not balanced among districts, prescription unreasonable situation is more serious in the peri-urban areas, the using level of national essential drug is low and prescription drug charges are too high in the central urban areas. Fourthly, the two lines of revenue and expenditure management will help to cut off the interests between the medical and pharmaceutical and promote the rationality of prescription medication. Fifthly, general practitioners’expertise is more abundant, which contributes to the promotion of prescription rationality of the community health service centers.Suggestions:The relevant policies and measures of the National Essential Medicines System should be impreoved to play the role of national essential drugs. The problems in the prescription drugs need to be solved by classification guiding. The responsibility of medical institutions should to be cleared to strengthen the prescription audits and management. The training on doctors must be strengthened to regulate the drug use behaviors. The publicity of rational drug use is expected to promote as to improving citizen’s medication knowledge.