【摘要】 目的:为北京市进一步实施国家基本药物制度提供参考。方法:采取定性研究中的焦点组访谈法进行调查,按照不同对象分为4个专题小组进行讨论,分别为卫生局和社区管理中心专题小组、基层医疗卫生机构专题小组、基本药物生产企业专题小组和药物配送企业专题小组,并就调查结果进行总结和分析。结果:卫生局和社区管理中心专题小组讨论认为,国家基本药物目录品种尚不能满足居民需求,目录遴选没有考虑人群和地区的差别。基层医疗卫生机构专题小组讨论认为,基层和上级医疗卫生机构需建立统一的用药和诊疗制度,目录遴选应结合社会、经济发展和人群疾病谱的变化,基层医疗卫生机构费用补偿不到位导致医务人员基本药物使用意愿不强。基本药物生产企业专题小组讨论认为,基本药物的价格并不是越低越好,盲目降价最终会损害患者利益。药物配送企业专题小组讨论认为,解决居民反映的基本药物断货和缺货现象需要多环节入手,并不仅是配送的问题。结论:北京市基层医疗卫生机构实施国家基本药物制度面临的两个关键点是国家基本药物目录内的药物是否能满足居民的基本用药需求,以及对基层医疗卫生机构进行的费用偿付能否保证。建议政府采取措施对相关政策进行完善。更多还原

【Abstract】 OBJECTIVE:To provide reference for further implementation of National Essential Medicine System in Beijing area. METHODS:Focus group interview was adopted in qualitative investigation,and the focus groups were divided into 4 groups according to the different objects. The four focus groups were Health Bureau and community management center group,community health centers group,the essential medicine manufacturing enterprises group and essential medicine delivery enterprises group. Results of investigation were summarized and analyzed. RESULTS:Health Bureau and community management center group thought that National Essential Medicine list could not meet the need of the residents in the community and the differences of medicine selection were not considered among population and districts. Community health care institution group believed that primary medical institutions or at higher level should develop uniform medication,diagnosis and treatment system;medicine selection should consider about social and economical development and the change of spectrum of disease;compensation mechanism was not in place so that medical staff were not inclined to use essential medicines. Essential medicine manufacturing enterprises group considered that the lower price of essential medicine were not preferred;blindly price declining of essential medicine could eventually damage the interest of patients. Medicine delivery enterprises group thought that shortage and out of stock of essential medicines reflected by the residents should be resolved not only from the delivery field but also from many respects. CONCLUSIONS:The two key issues of the implementation of National Essential Medicine System faced by the community health centers in Beijing area are the list whether or not could meet the need of the residents in Beijing area as well as whether or not could guarantee the compensation of the local community health centers. The government should take measures to perfect the policy.更多还原