临床药师通过药品预算管理促进合理用药的实践  

Practice of Clinical Pharmacists in Promoting Rational Drug Use by Drug Budget Management

作　　者：郑婷婷[1] 李锦[1] 贺良[1] 杨冬[1] 李笠[1] 许保海[1] 甄健存[1] ZHENG Tingting;LI Jin;HE Liang;YANG Dong;LI Li;XU Baohai;ZHEN Jiancun(Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院,北京100035

出　　处：《中国药房》2018年第21期3005-3009,共5页China Pharmacy

摘　　要：目的:探索临床药师在药品预算管理中的作用,为合理用药提供参考。方法:介绍我院自2016年开展的药品预算管理创新实践,描述临床药师在合理用药管控中的职能作用,通过比较2014-2017年全院药占比、均次药费、处方合格率、药品费用以及2017年药事绩效管理指标整体完成情况等,评价药师在此管理中发挥作用的效果。结果:我院临床药师在药品预算管理中的主要职能作用是审核药品预算以突出合理用药、审核药品使用实行双向管控、审核处方医嘱优化药物治疗、参与动态监测实施超常预警、公示用药情况开展精准管控等。2014-2017年间,全院药占比、均次药费逐年下降,处方合格率逐年上升;2017年全院药占比、门急诊均次药费和住院例次药费分别较2016年下降了11.37%(22.14%vs. 24.98%)、12.98%(191.95元vs. 220.58元)、12.28%(3 464.40元vs. 3 949.19元),处方合格率达到96.49%,药事绩效管理指标整体完成情况良好,全部达到了预期目标。结论:临床药师在药品预算管理中发挥了重要作用,实现了有效控制医院用药成本,促进了临床合理用药。OBJECTIVE:To explore the role of clinical pharmacists in the drug budget management,provide the reference for rational drug use.METHODS:The practice of drug budget management innovation in our hospital since 2016 was introduced,and the role of clinical pharmacists in control of rational drug use was described.The role of pharmacists were evaluated by comparing drug proportion,average drug cost per time,the rate of qualified prescription,drug cost and the overall indicators of pharmaceutical performance management in our hospital during 2014-2017.RESULTS:Main functional role of clinical pharmacists in drug budget management of our hospital included checking drug budget to highlight rational drug use,implementing two-way control for drug checking,checking prescriptions and medical orders to optimize drug therapy,participating in dynamic monitoring to implement abnormal early warning,demonstrating drug use to carry out precise control,etc.During 2014-2017,drug proportion and average drug cost per time of hospital were decreased gradually,and the rate of qualified prescription was increased gradually.Compared with 2016,drug proportion,outpatient and emergency drug cost per time and inpatient drug cost per case were decreased by 11.37%(22.14%vs.24.98%),12.98%(191.95 yuan vs.220.58 yuan)and 12.28%(3 464.40 yuan vs.3 949.19 yuan)in 2017,respectively;the rate of qualified prescription reached 96.49%.The overall indicators of pharmaceutical performance management were well achieved and all of them achieved the expected goals in 2017.CONCLUSIONS:The clinical pharmacists play the important role in the drug budget management,and it is effective means to administrate drug cost and to promote the rational drug use.

关 键 词：药品预算管理 临床药师 合理用药 

分 类 号：R95[医药卫生—药学]