Abstract
To evaluate the utilization status of essential medicines in community health institutions, and identify problems hindering the implementation of the Essential Medicine System at community service centres in China. Twenty community health centers and community health stations in Beijing were surveyed during September 2014 (one year after implementation of the new essential medicines list) regarding stocking situation and utilization status of essential medicines at these centers. Simulatneously, opinions about the utilization of essential medicines were solicited through sem-structured interviews from the clinical staff at these centers. Average outpatient health expenditure information was obtained from Beijing Municipal Health Bureau to evaluate the financial impact. During our study, an average of 377 species of essential medicines were stocked by the community health institutions, only accounting for 53.9% of Beijing Essential Medicine List, and average 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 year by year from 2009 to 2013. Feedbacks from medical staff showed that some patients have negative perception of the essential medicines’ brands and major concerns about its quality. Our study found both the list and supplies of essential medicines could not meet the clinical need of patients at community health centres adequately. Furthermore, some existing essential medicine policies in practice had restricted the service capacity thus affecting the function of community health institutions, and brought additional negative impacts on the utilization of essential medicines. From the financial perspective, the inadequacy of essential medicine to meet clinical need and poor supply condition of many low-price drugs contributed much to the rise of average drug expenses, limiting the role of essential medicines to alleviate the problem of high financial costs of getting treatment.
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