【摘要】 目的分析北京市各行政区不同免费服药服务模式对患者参与率和财政支出费用的影响。方法采取回顾性研究方法,设计调查问卷,调查北京市各区严重精神障碍免费服药药品领取方式、患者参与人数、财政支出费用等内容。结果社区发药模式、专科发药模式的患者参与率分别为47.43%和34.58%,社区发药模式的患者参与率高于专科发药模式(χ2=543.424,P<0.001);单途径取药模式、多途径取药模式的患者参与率分别为40.56%、41.44%,多途径取药模式的患者参与率高于单途径取药模式(χ2=4.167,P=0.041)。社区发药、专科发药的患者年人均财政支出费用分别为(1 370.49±531.92)元/人和(1 487.88±464.79)元/人,比较差异无统计学意义(t=-0.347,P=0.739)。单途径取药、多途径取药的患者年人均财政支出费用分别为(1 374.36±434.38)元/人和(1 310.54±381.01)元/人,比较差异无统计学意义(t=0.313,P=0.759)。结论社区发药模式较专科发药模式,具有就近提供服务,并可同时享受其他多项公共卫生服务的优势;多途径取药模式增加了患者选择余地,减少了单途径取药的选择局限性。北京市各行政区执行统一的免费药品目录,避免出现因属地不同带来的免费药品品种供给差异。更多还原

【Abstract】 Objective To analyze the participation rate and fiscal expenditure of different patterns in free medication service for serious mental disordered patients among districts in Beijing. Methods A retrospective study was conducted in districts of Beijing. The questionnaire involved service patterns,number of participating patients and fiscal expenditure. Results The participation rate of patients in community medication offering pattern and hospital medication offering pattern were47. 43% and 34. 58% respectively,the participation rate in community medication offering pattern was higher than that in hospital medication offering pattern( χ2= 543. 424,P < 0. 001). The participation rate of patients in one-path medication acquisition pattern and multi-path medication acquisition pattern were 40. 56% and 41. 44% respectively. The participation rate in multi-path medication acquisition pattern was higher than that in one-path medication acquisition pattern( χ2= 4. 167,P =0. 041). The per capita fiscal expenditure in community medication offering pattern and hospital medication offering pattern were( 1 370. 49 ± 531. 92) RMB and( 1 487. 88 ± 464. 79) RMB respectively every year,but showed no significant difference( t =-0. 347,P = 0. 739). The per capita fiscal expenditure in one-path medication getting pattern and multi-path medication getting pattern were( 1 374. 36 ± 434. 38) RMB and( 1 310. 54 ± 381. 01) RMB respectively every year,there were no significant difference( t = 0. 313,P = 0. 759). Conclusion Comparing with hospital medication offering patterns,community medication offering patterns performed with more advantage on providing medication service to patients nearby,and more patients acceptable than other patterns of public service. Multi-path medication getting pattern could give patients more choices comparing to one-path medication getting pattern. Using the same free medicine list could avoid prescription difference among districts owing to supplement.更多还原