新医改形势下药师参与住院药费控制成效分析  

Effect analysis of controlling the medical fees of inpatients by pharmacists in new medical reform program

作　　者：刘杨从[1] 张韶辉[1] 郭珩[1] 叶小春[1] 刘金伟[1] 魏天龙[1] 李璐璐[1] 邓体瑛[1] 张耕[1] 

机构地区：[1]武汉市第一医院药学部,湖北武汉430022

出　　处：《中国医院药学杂志》2018年第2期189-191,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:通过对药师参与住院药费控制的成效分析,旨在为医改形式下药师参与药费控制提供参考借鉴。方法:在医院政策支持下,各部门密切协作,药师参与药费控制,采取系列措施:制定辅助用药目录与排他性药物目录、开展处方点评、利用信息手段实施事前干预、鼓励药师事前干预/在线干预、开展临床合理用药宣教等。统计分析药师参与住院药费控制前后西成药占比、医院自制药及中药占比、主要治疗药物及辅助用药占比、人均总费用及人均药费的变化。结果:住院西成药占比降低10.65%,达到医院预期目标。其中辅助用药下降幅度最大;零加成后主要治疗用药占比上升21.15%,医院自制药品及中药占比上升173.23%。人均药费及人均总费用较前减少不明显,符合医改总体目标。结论:新医改形式下药师参与住院药费控制成效显著,可发挥不可替代的职业价值。OBJECTIVE To provide a reference method for other hospitals to control the medical fees.METHODS Under the hospital policy support and the close cooperation among various departments,pharmacists participated in drug cost control by adopting series of measures：drafting the hospital auxiliary drug directory and exclusive drug directory,carrying out prescription comment,using information means prior intervention,encouraging pharmacists intervention online or intervening in advance,clinical rational drug use education etc.The variations of drug amount proportion were analyzed and compared d for generic medicines,hospital homemade drugs and the traditional Chinese medicines,the main treatment medicines,the auxiliary drugs,the total personal costs and the personal drug costs,after the pharmacists took part in controlling the medical fees.RESULTS The generic medicine proportion was decreased by 10.65% relative to the baseline before pharmacists participated,which reached the hospital goals.The auxiliary medicine drug proportion had the biggest decline.Main treatment medicine proportion increased by21.15%and the hospital homemade medicines and traditional Chinese medicines drug proportions increased by 173.23%.However the personal costs and the total personal drug costs had decreased less.CONCLUSION Pharmacists can play an irreplaceable professional role for controlling the medical fees of inpatients in the new medical reform program.

关 键 词：医改 药品零加成 药师 药费控制 干预成效 

分 类 号：R956[医药卫生—药学]