2010~2016年医保住院患者中药注射剂使用分析  

Analysis of the Use of Traditional Chinese Medicine Injections in Inpatient with Medical Health Insurance During 2010~2016

作　　者：孙雪林[1] 周磊[1] 胡欣[1] SUN Xue-lin;ZHOU Lei;HU Xin(Department of Pharmacy,Beijing Hospital,National Center of Gerontology,Assessment of Clinical Drugs Risk and Individual Application Key Laboratory,Beijing 100730,China)

机构地区：[1]北京医院药学部国家老年医学中心,药物临床风险与个体化应用评价北京市重点实验室,北京100730

出　　处：《中国合理用药探索》2020年第12期5-9,共5页Chinese Journal of Rational Drug Use

摘　　要：目的:了解中药注射剂在住院患者中的使用情况,为中药注射剂在医疗机构的使用、医保政策的制定和完善提供依据和建议。方法:调取2010年1月1日~2016年12月31日中国医疗保险研究会抽样医保数据库中住院患者中药注射剂的使用数据,分析中药注射剂的使用规律、品种发展变化特点以及医保药品使用限定的效果。结果:2010~2016年,①住院患者中药注射剂费用持续增长,包括《国家基本医疗保险、工伤保险和生育保险药品目录》限制品种和非限制品种,自177.96亿元增长至397.47亿元。②由于医疗机构和病种双重限制,中药注射剂费用增长率有所放缓,但其绝对值高,仍保持着稳定增长,限病种费用由45.17亿元增加至109.03亿元;并且逐渐向三级医院集中,自34.31%人次分布增加至48.15%。③该目录内限心脑血管病和限恶性肿瘤中药注射剂品种保持增长趋势,超适应证用药现象明显。结论:2010~2016年,中药注射剂在住院患者中的使用人次、药品费用和医保报销金额持续增加,超适应证用药明显,限适应证对中药注射剂的影响有限,应加强中药注射剂使用合理性评价和药品政策监管。Objective:To understand the use of traditional Chinese medicine injection in hospitalized patients,and provide the basis and suggestions for the use of traditional Chinese medicine injection in medical institutions,the formulation and improvement of medical insurance policies.Methods:Data about the usage of Chinese medicine injection in inpatients were drawn from the medical insurance database sampled by the China Health Insurance Research Institution from January 1,2010 to December 31,2016.The application pattern of Chinese medicine injection,development and change of varieties of traditional Chinese medicine injection as well as the effect of limiting medicare drug use were discussed.Results:From 2010 to 2016,the cost of traditional Chinese medicine injections for patients in hospitals increased continuously,including restricted and non-restricted varieties in the medical insurance catalog,rising from 17.796 billion to 39.747 billion.Due to the dual restrictions on medical institutions and diseases,the cost growth rate of traditional Chinese medicine injection has slowed down.But the absolute value is highand still maintains a steady growth,with the cost on restricted diseases increasing from 4.517 billion to 10.903 billion.The cost is gradually concentrated on tertiary hospitals,increasing from 34.31%in 2010 to 48.15%in 2016.The drug variety for cardiovascular diseases and tumors in the catalog maintained an increasing trend,and the phenomenon of hyper indications was obvious.Conclusion:From 2010 to 2016,inpatients using traditional Chinese medicine injections,drug expenses and insurance reimbursement amount increased continually.Medication for hyper indications is obvious.Restricted indications have little effect on Chinese medicine injection,which calls for enhancing the rational evaluation on the traditional Chinese medicine injections and regulation of drug policy.

关 键 词：中药注射剂 药品金额 用药分析 医疗保险 住院患者 

分 类 号：R969[医药卫生—药理学]