基于大数据的医院基本药物应用状况横断面调查  

Cross Sectional Survey on the Application of Essential Drugs in Hospitals Based on Big Data

作　　者：叶露 陈红斗 杨晴晴[1,2] 张婷 唐婉 王梦雷 丁德喜 郑芳芳[1,2] 陆瑶 YE Lu;CHEN Hongdou;YAGN Qingqing;ZHANG Ting;TANG Wan;WANG Menglei;DING De-xi;ZHENG Fangfang;LU yao(The Affiliated Suqian Hospital of Xuzhou Medical University,Suqian,Jiangsu 223800,China;Suqian People's Hospital of Nanjing Drum-Tower Hospital Group,Suqian,Jiangsu 223800,China;Yancheng First People's Hospital,Yancheng,Jiangsu 224006,China)

机构地区：[1]徐州医科大学附属宿迁医院药学部,宿迁市223800 [2]南京鼓楼医院集团宿迁市人民医院药学部,宿迁市223800 [3]盐城市第一人民医院药学部,盐城市224006

出　　处：《药学与临床研究》2021年第3期233-236,共4页Pharmaceutical and Clinical Research

基　　金：江苏省卫计委高层次人才“六个一工程”拔尖人才科研项目(LGY2017057);江苏省卫计委医学科研课题(X2017009);江苏省医院协会医院管理创新研究课题(JSYGY-3-2019-516);江苏省第五期“333工程”科研项目(BRA2020234);江苏省药学会-天晴医院药学基金科研课题(Q202043)。

摘　　要：目的:分析某三甲医院使用基本药物的四个角度指标状况,为医院及监管部门制定并落实基本药物制度相关指标提供参考依据。方法:通过横断面调查的方法,采集某三甲医院2019年的HIS系统的基本药物的可及性、可负担性、安全性及合理性四个角度共8个指标[基本药物配备率(A1)、基本药物金额占比(A2)、基本药物DDDc与总体药物DDDc比值(B3)、医院抽检药品不合格率(C4)、医院基本药物发生严重ADR与严重ADR总数比值(C5)、门诊处方基本药物使用率(D6)、住院医嘱基本药物使用率(D7)、基本药物在用药前50中品种比例(D8)],并比较每个指标与当年政府制定的基本药物使用考核指标情况,政府没有制定指标的,以国家或省当年的均值做参考,均值数据采集全国医药经济信息网数据库、国家药品不良反应检测网ADR数据库、国家药品抽检信息系统和共享平台抽检报告数据库大样本基本药物数据。结果:2019年该医院的8个指标分别为:A1:45%;A2:23.73%;B3:30.98%;C4:26.92%;C5:0;D6:58.34%;D7:97.94%;D8:12%。8个指标有5个指标达到政策考核的指标值或国家省市的均值;但A2、B3、D8没有达到均值。结论:通过横断面调查显示,医院的基本药物实施情况大多数指标达到了政策考核要求;但也反映出基本药物的合理性指标等存在的问题。通过信息化的大数据方法,实现对医院使用基本药物情况的调查分析,采集速度快,准确性高。Objective:To provide reference for hospitals and regulatory authorities to formulate and implement relevant indicators of essential drugs system in four perspectives.Methods:By means of cross-sectional survey,data of 8 indicators,covering the four perspectives of accessibility,affordability,safety and rationality,of essential drugs in the HIS system of a'Grade A Tertiary'hospital in 2019,were collected.The 8 indicators were the ratio of the allocation of essential drugs(A1),the proportion of the sum of essential drugs(A2),the ratio of essential drug DDDc to overall drug DDDc(B3),unqualified rate of drug sampling inspection in the hospital(C4),the ratio of severe ADR of essential drugs to the total ADR in the hospital(C5),outpatient prescription rate of essential drugs(D6),the utilization rate of essential drugs prescribed for inpatients(D7),the proportion of essential drugs in the top 50 varieties(D8).Each indicator was compared with the assessment index of essential drugs use established by the government in that year.If the government does not set a target for an indicator,its mean value of the year of the country or province was taken as a reference,which was collected from the National Medical Economic Information Network,the National Adverse Drug Reaction Monitoring System or the National Drug Sampling Inspection Information System.Results:In 2019,the eight indicators of the hospital were as follows:A1:45%;A2:23.73%;B3:30.98%;C4:26.92%;C5:0;D6:58.34%;D7:97.94%;D8:12%.Five of the eight indicators reached the policy assessment target value or the mean value of the country or province,while A2,B3 and D8 failed.Conclusion:The cross-sectional survey showed that most of the indicators of the implementation of essential drugs in the hospital met the requirements of the policy assessment,but it also revealed problems of indicators for the rationality of essential drugs.Through the big data method,the investigation and analysis of the use of essential drugs in hospitals can be achieved with fast speed and high accura

关 键 词：基本药物 横断面调查 药物利用研究 大数据 

分 类 号：R95[医药卫生—药学]