我院儿科药品按剂量收费模式的建立与应用  

Establishment and Application of Charge-by-dose Model for Pediatric Drugs in Our Hospital

作　　者：李红云[1] 苏华[1] 芦霜 刘丽娟[2] LI Hongyun;SU Hua;LU Shuang;LIU Lijuan(Pharmacy Intravenous Admixture Service,the Second People’s Hospital of Liaocheng/Liaocheng Second Hospital Affiliated to Shandong First Medical University,Shandong Linqing 252600,China;ICU,the Second People’s Hospital of Liaocheng/Liaocheng Second Hospital Affiliated to Shandong First Medical University,Shandong Linqing 252600,China)

机构地区：[1]聊城市第二人民医院/山东第一医科大学附属聊城二院静脉用药调配室,山东临清252600 [2]聊城市第二人民医院/山东第一医科大学附属聊城二院重症医学科,山东临清252600

出　　处：《中国药房》2020年第17期2158-2162,共5页China Pharmacy

基　　金：山东省医药卫生科技发展计划项目(No.2017WSA-15108)。

摘　　要：目的:建立我院儿科药品按剂量收费模式,为减少患者支出、节约医保资金、降低科室药占比提供参考。方法:自2019年6月起,我院选择12种用量大、价格高、节余多的药品建立儿科按剂量收费药品目录,将目录内药品拆分为1/2或1/5小规格药品实行按剂量收费模式;制定按剂量收费模式的相关工作流程、质量控制标准及结余(亏损)药品记录,各药房与儿科科室间协调儿科药品使用。比较2019年6-12月按剂量收费模式与按支数收费模式(同时期药品用量换算的理论值)下拆分药品的使用数量、金额和儿科科室药占比。结果:2019年6-12月,在按剂量收费模式与按支数收费模式下拆分药品的每月使用量分别为(3346.43±734.73)支和(6821.71±1468.81)支,每月药品使用金额分别为(53576.03±10958.78)元和(112642.75±21308.77)元,差异均有统计学意义(P<0.05)。4个小儿内科和1个新生儿科药占比均有不同程度降低。结论:儿科药品按剂量收费可以减少药品使用量,减少药品费用支出,节约医保资金,降低科室药占比。OBJECTIVE:To establish charge-by-dose model for pediatric drugs in our hospital,so as to provide reference for reducing patients’expenditure,saving medical insurance funds and reducing drug proportion.METHODS:Since June 2019,a total of 12 kinds of drugs with heavy usage,high price and large savings in our hospital were selected to establish pediatric charge-by-dose list.The drugs included in the list were split into 1/2 or 1/5 small-sized drug for charge-by-dose model.The process,quality control standards and surplus(loss)drug record of charge-by-dose model were formulated to coordinate the use of pediatric drugs between pharmacies and pediatric departments.The quantity and amount of drugs which were split,and the drug proportion in pediatric departments were compared between charge-by-dose model and charge-by-unit model(theoretical value of dosage conversion in the same period)during Jun.-Dec.2019.RESULTS:From Jun.to Dec.2019,the quantities of split drugs each month with charge-by-dose model and charge-by-unit model were(3346.43±734.73)and(6821.71±1468.81);the amounts of split drugs each month with two models were(53576.03±10958.78)yuan and(112642.75±21308.77)yuan,respectively,with statistical significance(P<0.05).The drug proportion in four pediatric internal medicines departments and one neonatal medicine department had decreased to varying degrees.CONCLUSIONS:Pediatric drug charge by dose can reduce the use and amount of drugs,save medical insurance expenditures,decrease the drug proportion of department.

关 键 词：儿科用药 收费模式 按剂量收费 药品节余 药品使用量 药品使用金额 药占比 

分 类 号：R952[医药卫生—药学]