新型临床用药管理模式对医院用药成本的影响  

Effects of new clinical medication management mode on hospital medication cost

作　　者：王春祥 徐铭军[2] 薛刚 费秀珍[1] 余碧勇 赵九艳 李新 彭欣欣 王艺淋 周莹桦 赵彦栋 WANG Chunxiang;XU Mingjun;XUE Gang(Department of Pharmacy,Huairou Hospital for Maternal and Child Health,Beijing 101400,China;不详)

机构地区：[1]首都医科大学附属北京妇产医院怀柔妇幼保健院药剂科,北京市101400 [2]首都医科大学附属北京妇产医院怀柔妇幼保健院办公室,北京市101400

出　　处：《河北医药》2022年第8期1208-1211,共4页Hebei Medical Journal

基　　金：北京市教育委员科技计划、社科计划批准立项项目(编号:KM201810025027)。

摘　　要：目的探讨新型临床用药管理模式即“区办市管”模式对医疗机构药占比和门诊患者次均药费、住院患者例均药费等临床用药情况的影响。方法通过利用对处方、住院医嘱点评并结合行政干预的科学管理手段,强化临床合理用药培训,吸纳三级医院药品使用管理经验,将药品预算细化到科室,管控重点药品、重点医生,将管控结果在院级行政会议上进行公开通报等“区办市管”模式,对我院2017年(管控前)及2018年(管控后)的相关用药指标进行比较。结果与管控前比较,平均处方金额下降[管控前:(124.46±10.92)元,管控后:(110.69±3.68)元];用药品种数减少[管控前:(3.16±0.21)种,管控后:(2.20±0.15)种];次均药费、例均药费[管控前:(121.13±16.08)元、(1171.00±11.21)元,管控后:(97.45±8.35)元,(964.89±10.15)元]均显著下降;药占比[管控前:(42.38±4.52)%,管控后:(33.39±2.72)%]显著下降;重点监控药品(辅助用药)使用金额[管控前:(30.82±5.65)万元,管控后:(15.42±4.72)万元]显著减少;中成药使用金额占比[管控前:(56.45±4.26)%,管控后:(52.32±3.54)%]下降;门诊抗菌药物使用率[管控前(18.53±0.49)%,管控后(17.48±0.62)%]下降;住院抗菌药物使用率升高[管控前(48.57±3.93)%,管控后(57.06±2.29)%],差异均有统计学意义(P<0.05)。结论“区办市管”模式使医院用药成本明显下降,显著提高药品使用的合理性,最终形成医院与患者双赢格局,值得推广应用。Objective To investigate the effects of new clinical medication management mode-“district performance and municipal management”on hospital medication cost.Methods The medication indexes in our hospital were observed and compared between 2017(before managemengt and control)and 2018(after managemengt and control),and the indexes included prescription review,scientific management means of administrative intervention,and linical actual needs of rational use of drug,the use rate of antibiotics and the use amount of key monitoring drugs.Results Comparing with those in 2017,the average prescription amount was decreased,and the average number of medication variety was decreased;the use rate of antibiotics in outpatient and inpatient was decreased,and the proportion of antibiotics was decreased significantly(P<0.05).Moreover the use amount of key monitoring drugs(auxiliary drugs)was decreased significantly,and the average cost of outpatient and inpatient medication expenses was decreased significantly(P<0.05).Conclusion The application of“district performance and municipal management”mode can obviously decrease the medication cost,and improve significantly the rational use of drugs,so as to obtain a win-win deal between hospitals and patients.

关 键 词：处方医嘱点评 行政干预 合理用药 

分 类 号：R969.3[医药卫生—药理学]