Study On Related Encouraging Policies About The Priority Of Essential Drugs In Primary Medical And Health Institutions

BackgroundThe essential drug system is an important part of our country’s public health policies. To establish the essential drug system is one of the five key points of medical reform from2009to2011in our country. Ministry of health demands that the primary medical and health institutions and other medical institutions need to equip and use the essential drugs in the practice document about establishing country essential drug system. The essential drug system has covered all of the primary medical and health institutions established by government. During the twelfth developing period, our country will consolidate and perfect the essential drug system and implement in the village clinics and primary medical and health institutions established by non-governmental departments. According to the medical reform policy, all primary medical and health institutions should equip and use the essential drugs, and other medical institutions should make the essential drugs as their first choice and confirm its using percent. At present, we need to formulate the encouraging policy about the priority of essential drugs in medical and health institutions to form the situation of essential drug system which satisfies the need of all of the hospitals, doctors and patients.ObjectivesThrough literature review and on-site research, this study summarized and analyz ed the policies about encouraging basic medical institutions to use national essential m edicine as a priority, and provided the relevant policy recommendations on giving prio rity to encourage the use of national essential drug, which would finally reach the goal s that the hospitals are willing to equipped with essential drugs, the doctors are willing to prescribe, and the patients are willing to use the essential drugs. MethodsFirstly, we reviewed the related encouraging policies about essential drug system. Then, we chose Linyi, Weifang, and Jining in Shandong province as our survey sites. In each city, we chose one or two counties, and in each county, we surveyed3-5basic medical institutions established by government and1-2basic medical institutions established by non-governmental departments. The directors, doctors and pharmacists in our survey sites are selected to finish a questionnaire and be interviewed.ResultsThe basic medical institutions, which act as the basest and main providers of national health services, are the subjects of implementation essential drug system. In our survey, the ten community health service institutions have implemented essential drug system and established rules and regulations of the use and administrate of essential drugs since2011, but they didn’t equip other drugs except essential drugs. The stakeholders of the institutions highlighted the advantages of implementation of national essential drug system, and also pointed out the main problem, including the imperfection of the essential drug list, the long period of update, the shortage of common drugs and lack of financial input.Suggestions●Establish and start the dynamic adjustment mechanism of national essential drug list, shorten the update cycle, adjust the current national essential drug content each year under consideration of related health insurance content.●Increase the proportion of reimbursement or establish the special allowance system of national essential drugs to enhance its attraction and compliance to patients. Make patients pay for only20%～35%drug cost through increasing the proportion of reimbursement to65%～80%or through the special allowance system.●Reform the mechanism of procurement and distribution of essential drugs, provide special subsidies to essential drug producers.●Guarantee the financial aid for medical institutions and strictly implement the essential drug zero rate sales policy.●Reform the personal system and performance appraisal system in the medical institutions. ●Check the price of essential drugs reasonably and adjust the cost standard of diagnosis and treatment.●Clear the organizational leadership of the medical institutions who conduct the essential drug system.●Train for health staff about essential drug system and strengthen social propaganda.●Speed the progress of legislative control and perfect the monitoring and evaluation framework of essential drugs.