Objective To investigate the influence of essential medicines system ( EMS ) on the operation of community health centers ( CHCs ) . Methods The present status of outpatient visits, inpatient visits, fiscal compensation and personnel loss of medical institutions in Zhabei District after EMS implementation were evaluated through a combination of quantitative and qualitative approaches. Results After the implementation of EMS, the outpatient visits, inpatient visits, drug proportion, and total income rise all decreased in CHCs. The year - on - year income increase of 4. 82% was maintained mainly through outpatient income rise. Fifteen out of 45 ( 33% ) general practitioners suggested decreased income, while no significant personnel loss was observed. Conclusion The essential medicine list should be adjusted according to the changing needs. Doctors should be trained about the application of the drugs on the list to promote their use.%目的 了解基本药物制度在社区卫生服务中心的实施现况,探讨其对医疗机构运行状况的影响.方法 采用定量与定性研究相结合的方法,对基本药物制度实施前后上海市某区各级医疗机构的门诊量、住院量、财政补偿、人员流失等情况开展调查.结果 基本药物制度实施后,社区卫生服务中心门诊量、住院量、药占比均下降,总业务收入增幅也同步减缓,但仍然保持4.82%的同比增长率,收入增长主要体现在门诊收入的增长.此外,基本药物制度实施后33%(15/45)的全科医生表示收入下降,但人员流失不显著.结论 建议动态监测基本用药需求,合理调整基本药物目录;加强培训和宣传,促进药品合理使用;积极探索补偿机制,深化医疗卫生事业公益性改革.
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