Impact Of Essential Medicines Policies On Practitioners Of Primary Health Care Institutions

BackgroundIn the world,the organic combination of essential medicines policies and rational drug use has achieved remarkable results and has become an excellent demonstration of the rational use of medical resources.As one of the important institutional systems for the establishment of a basic medical and health system covering urban and rural residents and the realization of basic medical and health services for all,the national essential medicines system is constituting the reform of the Chinese medical system together with the basic medical insurance system and the primary medical and health care system.In September 2018,the state issued a call to further improve the national essential medicine policies,and the development of essential medicines policies entered a new historical stage.The core of the essential medicines policies,lies in the rational use of drugs.In the process of implementing the essential medicines system,it is crucial to extend the system construction into a broader strategy for the use of essential drugs.ObjectiveIn the context of the implementation of the essential medicine system?this study is providing relevant data and references to promote the usage of essential drugs and rational medication at primary level by understanding the status of drug use behavior and its influencing factors in the medical staff and practitioner of primary healthcare institutions in the context of the implementation of the essential medicine policies.Data and Methods The literature review was used to summarize the practical experience of different policy models for the essential medicines system at home and abroad,which laid the theoretical foundation for further studying the influence of the essential medicines policies on the medication behavior of primary medical personnel.The questionnaire survey was used to investigate the medical practitioner of primary health care institutions.It was confirmed that all of them were from basic medical and health institutions in various cities.And these medical staff or other participants qualified for diagnosis and treatment were included in the study.The questionnaire data was recorded using Epidata and analyzed using SPSS.Firstly,the descriptive study was used on the basic data of the study subjects,the changes in the medication behaviors of medical practitioner at primary level and evaluations of basic medical systems performed by primary medical personnel.Then it was tested the correlation between the demographic data of primary medical personnel,administered on essential medicines policies and medication behavior using the Chi-square test.Finally,two-category Logistic regression analysis was performed on the influencing factors of changes in medication behaviors of primary medical personnel.ResultsIn the implementation of essential medicines policies,the incidence of medication behavior promotion and the increase on usage of essential drugs among medical practitioner of primary health care institutions was high(P<0.05).Demographic data showed that professional and practicing qualifications had statistically significant differences in medication behavior among medical personnel(P<0.05).In the evaluation performed by grass-roots medical personnel,medication training in basic medicines,changes in workload,and whether or not performance assessment has statistically significant differences in the changes of medication behaviors among primary medical personnel(P<0.05).The regression analysis results showed that there were differences in medication behaviors among different medical professionals(P<0.05),pharmacy,nursing and other professional medical staff improve the proportion of essential medication is lower than medical professionals.Whether the workload was changed and performance testing was carried out on medication behavior,the difference in changes of medication was statistically significant.If the other conditions unchanged,medical staff with varying workloads are more likely to have medication changes than medical staff with unchanging workloads,OR= 4.392(2.148?8.979).And there is a positive correlation between performance appraisal and changes in medication behavior of medical staff,OR=2.417(1.207?4.839).Conclusion and SuggestionThe implementation of essential medicine policies affects the medication behavior of medical personnel at the primary health care institutions.Medical staff differed in the recognition and use of essential drugs with different professional backgrounds.And workload and performance appraisal are also important factors influencing the use of medicines by primary medical practitioners.In order to further develop the essential medicines policies,it's suggested to protect the supply of essential medicines and consolidate the basics of medication for medical staff,to strengthen the ability management of prescribers with modeling the rational use of drugs,and to form reasonable incentive strategies for increasing the willingness to use essential medicines.