我国基层医疗机构药学服务现状及问题研究(二):药师队伍建设现状分析
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摘要
目的:通过调查了解我国基层医疗机构药师队伍建设情况,分析其现有问题,并提供相关政策建议。方法:采用问卷调查形式收集我国基层医疗机构药师的高等教育背景、药学培训情况、从业现状和职业认知等信息,并通过描述性统计分析相关数据。结果:样本内基层医疗机构药师的最高学历主要为大专(38. 1%)和本科(36. 9%);大多数药师接受过药品政策相关培训(87. 1%)和合理用药相关培训(92. 6%);药师职称主要集中于中级职称(43. 6%);药师的收入主要介于2 000～5 000元之间(78. 4%),超过三分之一的药师不满意当前工作收入(39. 3%);药师的日常工作主要为发药(94. 2%),认为需要参与用药方案制定(42. 0%)、药学查房(29. 9%)的药师所占比例较低。结论:我国基层医疗机构药师的总体学历层次相对较低,药师培养制度、激励制度有待进一步完善,药师职业认知有待增强。
OBJECTIVE To investigate the pharmacist staffing in primary healthcare institutions in China,and based on the investigation results to analyze the existing problems and provide suggestions accordingly. METHODS A questionnaire survey was conducted to collect information about pharmacist educational background,training experience,employment,and awareness of their occupation in primary healthcare practice in China. Descriptive statistics analysis was used to process these data. RESULTS Most of the pharmacists investigated had got a junior college(38. 1%) or undergraduate degree(36. 9%); most pharmacists had received drugrelated training(87. 1%) and training in rational drug use(92. 6%); the pharmacist titles were mainly middle-level professional(43. 6%); per month income of the pharmacists was mainly between 2 000 and 5 000 yuan(78. 4%) and more than one-third of pharmacists were not satisfied with their current income(39. 3%); pharmacists' primary daily work was delivering drugs(94. 2%)and only a small proportion of pharmacists regarded participating in drug regimen development(42. 0%) and pharmaceutical rounds(29. 9%) as necessary. CONCLUSION The general education level of pharmacists in primary healthcare institutions in China is relatively low,and the pharmacist training system and incentive system need to be further improved. The pharmacist occupational awareness remains to be enhanced.
OBJECTIVE To investigate the pharmacist staffing in primary healthcare institutions in China,and based on the investigation results to analyze the existing problems and provide suggestions accordingly. METHODS A questionnaire survey was conducted to collect information about pharmacist educational background,training experience,employment,and awareness of their occupation in primary healthcare practice in China. Descriptive statistics analysis was used to process these data. RESULTS Most of the pharmacists investigated had got a junior college(38. 1%) or undergraduate degree(36. 9%); most pharmacists had received drugrelated training(87. 1%) and training in rational drug use(92. 6%); the pharmacist titles were mainly middle-level professional(43. 6%); per month income of the pharmacists was mainly between 2 000 and 5 000 yuan(78. 4%) and more than one-third of pharmacists were not satisfied with their current income(39. 3%); pharmacists' primary daily work was delivering drugs(94. 2%)and only a small proportion of pharmacists regarded participating in drug regimen development(42. 0%) and pharmaceutical rounds(29. 9%) as necessary. CONCLUSION The general education level of pharmacists in primary healthcare institutions in China is relatively low,and the pharmacist training system and incentive system need to be further improved. The pharmacist occupational awareness remains to be enhanced.
引文
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[26]Zhao JB,Chen FF.Discussion on Training and Incentive Mechanisms for Clinical Pharmacist in General Hospitals at the Grassroots Level[J].Chin J Rational Drug Use(中国执业药师),2014,11(Z1):60-63.
[27]Wang XL,Wei SY,Ji H.Establish a reasonable professional pharmacist title system,incentive mechanism and education system[J].Chin J Clin Pharm(中国临床药学杂志),2004(03):190-192.
[28]Li GZ,Luan JJ,Xu WK,et al.Incentive Mechanism of Clinical Pharmacist Management Based on ERG Theory[J].China Pharmacy(中国药房),2015,26(4):440-442.
[29]Peng HY,Wu XR,Wang LB.Using Organizational Behavior Principles to Establish Incentive Mechanism in Hospital Pharmacy Management[J].China Pharmacist(中国药师),2011,14(9):1385-1387.
[30]Cao HJ.Analysis and Intervention of Psychological Characteristics of Pharmacists in Primary Hospitals[J].XinliYesheng(心理医生月刊),2012,(7):459-459.
[31]Wei L.Investigation and Analysis of Pharmacists Understanding of Modern Pharmaceutical Care[J].Chin J Clin Rational Drug Use(临床合理用药杂志),2013,6(21):8-10.
[32]Qian XH,An LN.American and Chinese standardized training of pharmacists and its enlightenment[J].Central South Pharmacy(中南药学),2016,14(10):1134-1138.
[33]Zeng J.Brief Probe into Hospital Clinical Pharmacy Service[J].China Pract Med(中国实用医药),2011,6(2):250-251.
[2]Liu D,Li J,Li L,et al.Pharmacy Service and Pharmacist Role[J].Chin J Rural Med Pharm(中国乡村医药),2004(2):67-68.
[3]He XM,Chen C,Ma BZ,et al.Analysis on relativity between pharmic counseling and functionality of pharmacist[J].Chinese Hospitals(中国医院),2013,17(8):64-66.
[4]Xiang YC.On the Factors and Countermeasures of Restricting the Development of Licensed Pharmacists in China[J].China Pharmacist(中国药师),2003(2):76-77.
[5]Ren JX,Qiu ZQ.Problems and Countermeasures in the Construction of Pharmacy Talents[J].J Practi Med Techn(实用医技杂志),2004(12):1601-1602.
[6]Liu J,Jiang LJ.Overseas Community Pharmacist Service Model Overview[J].Medical Higher Vocational Education and Modern Nursing(国外医学(卫生经济分册)),2015,32(1):1-4.
[7]Li ZH.Brief introduction of foreign community pharmacist service model[J].Chinese Community Doctors(中国社区医师(医学专业)),2010,12(30):34.
[8]Xu CQ.Promoting the development of clinical pharmacy in China[D].Shenyang Pharmaceutical University(沈阳药科大学),2007.
[9]Liu GL.Current status of hospital pharmacy and discipline development of clinical pharmacists[J].World Clinical Drug(世界临床药物),2013,34(8):512-515.
[10]Nie XY,Chen J,Shi LW,et al.Characteristics of Pharmacist Talents Development in Developed Countries and Inspiration of Them on China[J].China Pharmacy(中国药房),2012,23(36):3451-3454.
[11]Pharmacy management rules for medical institutions(医疗机构药事管理规定)[EB/OL].(2011-04-07)[2018-06-13].http:∥www.satcm.gov.cn/fajiansi/gongzuodongtai/2018-03-24/2269.html.
[12]The CPC Central Committee and the State Council's Opinions on Deepening the Reform of the Medical and Health System(中共中央国务院关于深化医药卫生体制改革的意见)[J].China Pharmacy(中国药房),2010,21(4):289-294.
[13]Yang XQ.Analysis of problems existing in primary healthcare institutions under grading diagnosis and treatment and analysis of development countermeasures[J].J Clin Med Liter(临床医药文献电子杂志),2016,3(50):10054-10055.
[14]Jiang WJ.Pharmacy Service and Pharmacist Quality[J].Chinese and Foreign Communication(中外交流),2017,(9):30.
[15]Hepler C D,Strand L M.Opportunities and Responsibilities in Pharmaceutical Care.[J].Am J Pharm Edu,1989,53(3):533-543.
[16]Mcgivney M,Meyer S H W,Hall D,et al.Medication therapy management:ITS relationship to patient counseling,disease management,and pharmaceutical care[J].J Am Pharm Assoc,2007,47(5):620-628.
[17]Anderson C,Bates I,Beck D,et al.The WHO UNESCO FIP pharmacy education taskforce[J].Hum Resour Health,2009,7:45-53.
[18]General pharmaceutical council,pharmacist independent prescriber[EB/OL].[2017-04-23].http//www.pharmacyregulation.org/education/pharmacist-independent-prescriber.
[19]Cordero L,Cadavid MI,Fernández-Llimós F,et al.Continuing education and community pharmacists in Galicia:a study of Opinions[J].Pharm World Sci,2004,26(3):173-177.
[20]Jann B.Skelton Author Vitae;James A.Owen Author Vitae.Developing a vision and strategic action plan for future communitybased residency training[J].J Am Pharm Assoc,2016,56(5):584-589(e1).
[21]Wang XR,Liu RC.Analysis of the continued medical education in primary healthcare institutions[J].Chinese Remedies&Clinics(中国药物与临床),2012,12(2):267-268.
[22]Liu SY,Liu SL,Zhong Y.The Actuality and Development Countermeasures of Pharmaceutical Service in Primary Healthcare Institutions[J].J Clin Med Liter(临床医药文献电子杂志),2017,4(58):11481-11482.
[23]Xu ZJ.The status quo of knowledge and skills of pharmacy personnel in primary medical institutions and their training requirements[J].World Latest Medicine Information(世界最新医学信息文摘),2016,16(69):276+280.
[24]Su YQ,Long B,Deng QH,et al.Investigation analysis for the present situation of pharmacy staff in parts of primary medical and health institutions in Chongqing[J].China Pharmacy(中国药房),2016,27(9):1160-1162.
[25]Zeng L,Li J.Investigation of Hospital Pharmacists in 15 Provinces and Cities in the Background of Healthcare Reform in China[J].China Pharmacist(中国药师),2015,18:1714-1717.
[26]Zhao JB,Chen FF.Discussion on Training and Incentive Mechanisms for Clinical Pharmacist in General Hospitals at the Grassroots Level[J].Chin J Rational Drug Use(中国执业药师),2014,11(Z1):60-63.
[27]Wang XL,Wei SY,Ji H.Establish a reasonable professional pharmacist title system,incentive mechanism and education system[J].Chin J Clin Pharm(中国临床药学杂志),2004(03):190-192.
[28]Li GZ,Luan JJ,Xu WK,et al.Incentive Mechanism of Clinical Pharmacist Management Based on ERG Theory[J].China Pharmacy(中国药房),2015,26(4):440-442.
[29]Peng HY,Wu XR,Wang LB.Using Organizational Behavior Principles to Establish Incentive Mechanism in Hospital Pharmacy Management[J].China Pharmacist(中国药师),2011,14(9):1385-1387.
[30]Cao HJ.Analysis and Intervention of Psychological Characteristics of Pharmacists in Primary Hospitals[J].XinliYesheng(心理医生月刊),2012,(7):459-459.
[31]Wei L.Investigation and Analysis of Pharmacists Understanding of Modern Pharmaceutical Care[J].Chin J Clin Rational Drug Use(临床合理用药杂志),2013,6(21):8-10.
[32]Qian XH,An LN.American and Chinese standardized training of pharmacists and its enlightenment[J].Central South Pharmacy(中南药学),2016,14(10):1134-1138.
[33]Zeng J.Brief Probe into Hospital Clinical Pharmacy Service[J].China Pract Med(中国实用医药),2011,6(2):250-251.