武汉市高血压患者基本药物使用情况及影响因素分析

摘要

目的：调查分析武汉市社区高血压患者基本药物使用情况及其影响因素，为完善社区高血压患者基本药物政策提供建议。方法：通过多阶段分层随机抽样方法，对武汉市70个基层卫生机构（35个社区卫生服务中心和35个乡镇卫生院）的4177名高血压患者进行问卷调查。结果：83％的高血压患者使用基本药物，基本药物品种数占用药总品种数的81．8％；降压药物以西药和单一用药为主；基本药物的使用在并发症种类数、疾病经济负担和不同类型医疗保险之间分布具有统计学意义（P＜0．05）；1种并发症和2种及以上并发症患者使用基本药物的比例是无并发症患者的1．8倍和1．7倍；疾病经济负担非常重的患者使用基本药物的比例是疾病经济负担较轻患者的2．3倍；城镇居民医疗保险高血压患者使用基本药物比例是新型农村合作医疗保险高血压患者的2．1倍。结论：武汉市社区高血压患者使用基本药物情况较好；患有并发症、疾病经济负担较重和城镇居民医保患者更倾向选择基本药物控制高血压；基本药物目录能较好的满足社区高血压患者用药需求。%Objective:To analyze the antihypertensive use of hypertension patients in community of Wuhan in 2014 and impact factors for basic drug use, to give advice on the essential medicines list in Wuhan to hypertensive in communities in Wuhan.Methods:The gathered date was analyzed by Descriptive method, ANOVA, Chi-square and Logistic Model.Results: The essential medicines accounted for 83% of all the antihypertensive, and accounted for 81.8% of the essential medicines list.The antihypertensive is given priority to western medicine and the sin-gle drug.The distribution differences of ratio of essential medicines use are significant in terms of complications species number, economic burden and the different types of health insurances.Use ratio of essential medicines of the 1 complication group and two or more complications group are 1.8 times and 1.7 times over that of the non-complication group.For hypertension patients of the highest burden, their probable use of essential medicines is 2.3 times that low burden.The hypertensive with the medical insurance for urban residents using of the essential medicines is 2.1 times to the people with the new rural cooperative medical insurance.Conclusion:The basic antihypertensive use of hypertensive in community of Wuhan is good, the hypertensive are more likely to buy the basic drugs, and the main influence factors are complications species number, eco-nomic burden and the different types of health insurances., and the essential medicine is nearly covered the grass-roots health services in Wu-han.