药事干预控制医院药占比的效果分析  

Analysis on the Effect of Pharmaceutical Intervention on Controlling the Proportion of Drug Cost Accounting for Total Medical Expenditure

作　　者：林翼金 周立建[1] 欧阳玉龙 李亚男[1] 

机构地区：[1]丹阳市人民医院

出　　处：《医院管理论坛》2015年第2期53-56,共4页Hospital Management Forum

摘　　要：目的通过对医院合理用药整治活动效果的调查,了解所运用的各种干预措施对促进合理用药的效果,为进一步规范临床药物使用、降低药占比、减轻患者负担提供有效的干预手段。方法采集干预前、干预中和维持三阶段的医院药占比、门急诊及住院患者抗菌药物使用率、抗菌药物使用强度和抗菌药物金额比例等数据,进行趋势分析,了解干预效果及维持情况。结果干预前、干预中和维持三阶段的医院药占比、门诊及住院患者抗菌药物使用率、抗菌药物使用强度和抗菌药物金额比例分别是:(41%、22%、48%、65%、79%、34%);(37%、21%、40%、66%、60%、30%);(33%、7%、24%、54%、43%、21%)。医院药占比下降8%,门、急诊和住院抗菌药物使用率分别下降了15%、24%和11%,抗菌药物使用强度下降36DDD,抗菌药物金额比下降13%。结论通过抗生素分级管理、抗生素专项整治、医院合理用药专项整治、专科用药管理及鼓励优先使用基本药物等系列方案的实施,能够很好地诱导临床合理用药,有效控制药占比。Objective Through investigating the effect of remediation work on hospital rational drug use, learn the effect of different kinds of measures on promoting rational drug use, which could be an effective reference to further standardize the clinical use of drugs, reduce the proportion of drug cost accounting for total medical expenditure and reduce the burden on patients. Method Collected the proportion of drug cost accounting for total medical expenditure, antibiotics use rate of outpatients and inpatients, antibiotics use density and the cost of antibiotics before intervention, under intervention and maintenance, and conducted trend analysis to learn the intervention effect and maintenance situation. Results The proportion of drug cost accounting for total medical expenditure, antibiotics use rate of outpatients and inpatients, antibiotics use density and the cost of antibiotics for three phases are （41%, 22%, 48%, 65%, 79%, 34%）; （37%, 21%, 40%, 66%, 60%, 30%）; （33%, 7%, 24%, 54%, 43%, 21%）. The proportion of drug cost accounting for total medical expenditure dropped 8%, outpatient, emergency and inpatient antibiotics use rate decreased by 15%, 24% and 11% respectively. Antibiotics use density decreased 36DDD while the cost of antibiotics decreased 13%. Conclusion Through the implementation of a series of measures including hierarchical management on antibiotics, antibiotics special rectification, hospital rational drug use rectification, specialist medication management and encouragement priority use of essential drugs, clinical rational use of drugs could be well induced and the proportion of drug cost accounting for total medical expenditure could be effectively controlled.

关 键 词：基本药物 合理用药 抗菌药物 抗菌药物使用强度 药占比 

分 类 号：R726.4[医药卫生—儿科]