DRGs付费模式下临床药师参与神经内科药品成本管控效果分析  

Effect of Clinical Pharmacists on Drug Cost Control in Neurology Department Under DRGs Payment Model

作　　者：李黎[1] 朱亚宁[1] 张丹[1] 周楠[1] 张鹏[1] LI Li;ZHU Yaning;ZHANG Dan;ZHOU Nan;ZHANG Peng(Department of Pharmacy,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,China 710069)

机构地区：[1]陕西省人民医院药学部,陕西西安710069

出　　处：《中国药业》2022年第10期34-38,共5页China Pharmaceuticals

基　　金：陕西省创新人才推进计划-青年科技新星项目[2021KJXX-23]。

摘　　要：目的探讨疾病诊断相关分组(DRGs)付费模式下临床药师对医院药品成本管控的作用。方法选取医院神经内科2019年至2020年的住院患者,按患者数排名前3的疾病类型分为DRGs 1组(脑梗死,277例)、DRGs 2组(短暂性脑缺血发作,206例)、DRGs 3组(脑出血,189例)。上述3组再按临床药师是否干预成本管控,各分为干预前组(2019年)和干预后组(2020年)。临床药师分别在对医护人员进行DRGs付费政策宣教培训、优化临床用药方案、将处方前置审核与临床问题相结合、加大处方点评力度、动态监控神经内科用药情况等方面进行干预。结果各干预后组与相应干预前组的疗效、住院时间、药品不良反应发生率比较均无显著差异(P>0.05);与相应干预前组比较,各干预后组的用药品种数均显著减少,住院总费用、药品费用、药占比均显著降低(P<0.05),使用的部分(6/9)神经保护剂数量和金额明显减少。结论DRGs付费模式下临床药师能有效参与药品成本管控,在保障临床疗效和安全的基础上降低药品费用,促进DRGs的顺利实施。Objective To investigate the role of clinical pharmacists in hospital drug cost control under the diagnosis-related groups(DRGs)payment model.Methods The inpatients admitted to the neurology department of the hospital from 2019 to 2020 were divided into DRGsⅠgroup(cerebral infarction,277 cases),DRGsⅡgroup(transient ischemic attack,206 cases)and DRGsⅢgroup(intracerebral hemorrhage,189 cases)according to the number of patients in the top three disease types.A total of 672 patients were included.The patients in the above three groups were divided into the pre-intervention groups(2019)and post-intervention groups(2020)according to whether the clinical pharmacist carried out drug cost control or not.Clinical pharmacists intervened in the publicity and training of DRGs payment policy for medical staff,optimizing clinical medication schemes,combining prescription pre-review with clinical problems,strengthening prescription review,and dynamically monitoring the medication situation of the neurology department.Results There was no significant difference in the efficacy,length of hospital stay and incidence of adverse drug reactions between the post-intervention groups and the corresponding pre-intervention groups(P>0.05).Compared with those in the corresponding pre-intervention groups,the number of types of drugs used,total hospitalization cost,drug cost and drug proportion in the post-intervention groups decreased significantly(P<0.05),and the number and amount of some(6/9)neuroprotective agents used in the neurology department in the post-intervention groups decreased significantly.Conclusion Under the DRGs payment model,clinical pharmacists can effectively participate in drug cost control,reduce drug costs and promote the smooth implementation of DRGs on the basis of ensuring clinical efficacy and safety.

关 键 词：临床药师 疾病诊断相关分组 神经内科 成本管控 药事管理 

分 类 号：R95[医药卫生—药学]