医保控费对安徽芜湖某区6家非三级医院重点监控药品使用的影响  

Influence of Medical Insurance Cost Control on the Use of Key Monitored Drugs in Six Non-Tertiary Hospitals in a District of Wuhu City in Anhui Province

作　　者：杨慧 徐强 邓逸芸 张文[3] 周德喜[3] 许杜娟[1] YANG Hui;XU Qiang;DENG Yiyun;ZHANG Wen;ZHOU Dexi;XU Dujuan(College of Pharmacy,Anhui Medical University,Hefei,Anhui,China 230032;Wuhu Fanchang District People's Hospital,Wuhu,Anhui,China 241200;Yijishan Hospital of Wannan Medical College,Wuhu,Anhui,China 241000)

机构地区：[1]安徽医科大学药学院,安徽合肥230032 [2]安徽省芜湖市繁昌区人民医院,安徽芜湖241200 [3]皖南医学院弋矶山医院,安徽芜湖241000

出　　处：《中国药业》2022年第14期43-47,共5页China Pharmaceuticals

基　　金：皖南医学院中青年科研基金[WKS2019F03]。

摘　　要：目的促进医院重点监控药品合理用药、减少不合理支出、提高医保基金使用率。方法调取安徽省芜湖市某区3家二级综合医院、3家基层医院2019年至2020年重点监控药品采购及使用相关数据,分析药品用量与金额的变化趋势;总结2019年至2020年重点监控药品病历点评结果,评价重点监控药品的使用合理性。结果与2019年比较,2020年6家医院重点监控药品的平均使用品种数由(8.33±3.85)种降至(7.33±3.44)种,总费用由414.08万元降至228.89万元,采购金额占比从7.70%降至5.66%,占药品销售金额比例由6.97%降至5.10%,医保基金支出金额由30929.00万元降至25554.92万元,差异均有统计学意义(P<0.05)。2019年至2020年共点评重点监控药品8个,相关病历1770份,病历不合理率由25.14%降至8.48%(P<0.05);不合理类型主要为无适应证用药,主要体现为质子泵抑制剂及人血白蛋白等的使用指征不足。结论医保控费政策促进了重点监控药品的有效监管,该区多家二级及以下医院重点监控药品使用逐渐趋于合理,但仍需加强该类药品的专项点评,持续改进,以促进系统化、路径化、可评价的合理用药模式的形成。Objective To promote the rational use of key monitored drugs in hospitals,to reduce unreasonable expenditure,and to improve the utilization rate of medical insurance fund.Methods The procurement and use data of key monitored drugs were collected from three secondary general hospitals and three grass-roots hospitals in a district of Wuhu City of Anhui Province from 2019 to 2020,and the change trend of drug dosage and amount was analyzed.The review results of medical records of key monitored drugs from 2019 to 2020 were summarized to evaluate the rationality of the use of key monitored drugs.Results From 2019 to 2020,the average number of key monitored drugs in six hospitals decreased from(8.33±3.85)kinds to(7.33±3.44)kinds,the total cost of key monitored drugs decreased from 4.1408 million CNY to 2.2889 million CNY,the proportion of procurement sum of key monitored drugs decreased from 7.70%to 5.66%,the proportion of sales amount of key monitored drugs decreased from 6.97%to 5.10%,and the expenditure amount of medical insurance fund decreased from 309.2900 million CNY to 255.5492 million CNY,with significant differences(P<0.05).From 2019 to 2020,eight key monitored drugs with 1770 related medical records were reviewed,and the rate of unreasonable medical records decreased from 25.14%to 8.48%(P<0.05).The irrational type was mainly the use of drugs without indications,which was mainly reflected in the insufficient indications for the use of proton pump inhibitors and human albumin.Conclusion The policy of medical insurance cost control has promoted the effective supervision of key monitored drugs.The use of key monitored drugs in several secondary and lower level hospitals in this area gradually tends to be reasonable,but the special review of these drugs should be strengthened and continuous improvement should be made to promote the formation of a systematic,routinized and evaluable rational drug use model.

关 键 词：医保控费 重点监控药品 处方点评 合理用药 芜湖 药事管理 

分 类 号：R969.3[医药卫生—药理学]