2013—2017年我国六城市医疗机构急诊国家基本药物使用情况分析  

Analysis of the utilization of national essential medicines in the emergency department of medical institution in six cities of China during 2013—2017

作　　者：任佚[1,2] 胡欣 裴艺芳[1] 史录文[2] REN Yi;HU Xin;PEI Yi-fang;SHI Lu-wen(Department of Pharmaceutical Science,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation,Beijing 100730,China;Department of Pharmacy Administration and Clinical Pharmacy,Peking University School of Pharmaceutical Sciences,Beijing 100191,China)

机构地区：[1]北京医院药学部,国家老年医学中心,中国医学科学院老年医学研究院,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 [2]北京大学药学院药事管理与临床药学系,北京100191

出　　处：《中国新药杂志》2020年第23期2748-2755,共8页Chinese Journal of New Drugs

摘　　要：目的:调查、了解我国国家基本药物在医疗机构急诊的使用情况,为《国家基本药物目录》实施的相关研究提供参考,为促进基本药物制度和优先选用政策的落实提供依据。方法:利用中国药学会医院处方分析项目组数据库数据,统计分析2013—2017年我国六城市105家医疗机构急诊处方用药中化学药品和生物制品类药物信息,对各类基本药物用药品种数、用药金额、处方频次数等进行统计排序和分析,计算基本药物急诊使用率(覆盖率)和用药占比;计算药品用药频度(defined daily dose system,DDDs)及限定日费用(defined daily cost,DDC)。结果:研究共包含7 219 483条患者用药信息,急诊共配备使用2012版《国家基本药物目录》中化学药品和生物制品类药物272种(按药品通用名及规格计),占目录中全部317种同类药物的比例(覆盖率)较高(85.80%),但占全部急诊用药品种比例较低(15.43%);六城市急诊使用的基本药物品种数、金额和频次的占比差异不大;共涉及24大类药理学类别,用药金额排序前3位分别为调节水电解质酸碱平衡药物、抗微生物药物、消化系统用药;调节水电解质酸碱平衡的基本药物品规数最少(10,3.06%),但金额和频次每年均居首位,且占比很高(31.70%,63.74%),以输液为主;抗微生物类药物品规数最多(63,19.27%),金额排序位居第2,占比较高(25.30%);激素内分泌类药物品规数第2(54),应用也相对较多;前10类中金额排序最末位是维生素矿物质类药物,频次排序最末位的是解毒药;销售金额前20位的具体药品相对固定,每年变化不明显,基本药物进入全部急诊用药金额排名前20位的有5种,且金额相对较低;几种抗菌药物和抗凝药DDDs有逐年增加趋势,多种药物的DDC持平或逐年下降。将样本数据按照2018版《国家基本药物目录》进行统计并对比,急诊用药品种数占比为21.84%、急诊使用率为92.33%、急诊销售金Objective: To investigate the current status and characteristics of the use of national essential medicine in emergency department in six cities of China,and to provide data for further studies of implementation of the essential medicine system and the 2018 catalog of national essential medicine.Methods: Database from Chinese Pharmaceutical Association’s cooperative project team of prescription analysis was used to statistically analyze the data of chemical and biological essential medicines for emergency patients in six cities of China during2013—2017.The included variety,sale amount and frequency of essential medicines were ranked and analyzed.And the defined daily dose system(DDDs) and the defined daily cost(DDC) of those used much were calculated and analyzed.Results: 7 219 483 items of medications were included in this study.272 kinds of essential medicines cover 85.80% of all 317 kinds,but only 15.43% of all kinds of medications used in emergency department.There was little difference between six cities in the proportion of variety,sales amount and frequency of essential medicines.There were 24 pharmacological kinds included,the top 3 cost ones of which were electrolyte balance adjusted drugs,antibiotics and digestive system drugs.Electrolyte balance adjusted drugs included the least varieties(10,3.06%) but led to the highest cost(31.70%) and frequency(63.74%) every year while infusions contributed most.Antibiotics included the most varieties(63,19.27%) and led to a higher cost(25.30%),too.Hormone and endocrine system drugs included the second most varieties(54).In the top 10 applied kinds of medicines,vitamin and mineral drugs held the lowest sale amount,meanwhile antitoxins owned the least frequency.Medicines,which were in top 20 of sale amount in all of used in emergency department,were consistent every year during five years,but 5 kinds of the essential medicines were contained.DDDs of several antibiotics and anticoagulant in top20 were increased each year and DDC of most medicines were constant or

关 键 词：国家基本药物 急诊用药 用药金额 用药频度 限定日费用 

分 类 号：R969.4[医药卫生—药理学]