Analysis of the Utilization Status of Essential Medicines in Beijing's Community Health Institutions.

Abstract

To evaluate essential medicines utilization in community health institutions to identify problems hindering the implementation of the Essential Medicine System at community level in Beijing, China. A total of 20 community health centers in Beijing were surveyed during September 2014 regarding stocking situation and utilization status of essential medicines. Opinions about essential medicines utilization were solicited from clinical staff at these centers. Average outpatient health expenditure was obtained from the Beijing Municipal Health Bureau to evaluate the financial impact. During our study, an average of 377 species of essential medicines was stocked by the community health institutions, accounting for 53.9% of Beijing Essential Medicine List, and 61.6% of the total medicines in the institutions. First-aid and low-price essential medicines were frequently out of stock. The average expense per outpatient visit increased yearly from 2009 to 2013. Feedback from clinical staff revealed patients' negative perception of the essential medicines and major concerns about its quality. Our study found both the list and supply of essential medicines could not meet the clinical needs of patients at community health centers adequately. Furthermore, some existing drug policies had restricted the service capacity, thus affecting the centers' function and bringing additional negative impact on essential medicines utilization. Financially, the inadequacy of essential medicine to meet clinical need and poor supply of many low-price drugs contributed much to the rise of average drug expenses, limiting the role of essential medicines to improve the quality of care at the community level.