北京市某三级甲等综合医院药费精细化预算全程管理的实践与成效分析  

Practice and effect analysis of detailed budget management of drug expenses in a class A general hospital in Beijing

作　　者：张杨[1] 李哲[1] 程晟[1] 郭恒 沈素[1] 李新刚 ZHANG Yang;LI Zhe;CHENG Sheng;GUO Heng;SHEN Su;LI Xingang(Department of Pharmacy,Beijing Friendship Hospital,Capital Medical University,Beijing100050,China)

机构地区：[1]首都医科大学附属北京友谊医院药学部,北京100050

出　　处：《中国医药导报》2023年第3期180-183,共4页China Medical Herald

基　　金：国家自然科学基金青年科学基金项目(82104310);北京友谊医院科研启动基金资助项目(yyqdktzx2020-1)。

摘　　要：目的 总结首都医科大学附属北京友谊医院(以下简称“我院”)药费全程管理的措施与成效,为新形势下公立医院药事管理提供参考。方法 介绍我院药费管理主要举措,统计分析2016—2019年门诊药品总金额数、住院药品总金额数、辅助用药总金额数、门诊患者总人次数和出院患者总人次数情况,比较4年的门诊次均药费、住院次均药费和辅助用药金额占比,综合评价管理成效。结果 2016—2019年,我院门诊次均药费逐年降低,与前一年度比较,2017、2018和2019年分别降低4.86%、1.67%和9.20%(P<0.05)。住院次均药费逐年下降,与前一年度比较,2017、2018和2019年分别降低5.31%、0.05%和1.65%(P<0.05)。辅助用药金额占比逐年减少,与前一年度比较,2017、2018和2019年分别降低18.45%、24.82%和5.83%(P<0.05)。结论 我院多部门上下联动、内外协同、齐抓共管,形成了“预算牵头、绩效收尾、精细到科、全程管理”的药费管理模式,有效降低了门诊和住院次均药费,减少了辅助用药,提高了合理用药水平。Objective To summarize the practice and effect of pharmaceutical administration in Beijing Friendship Hospital, Capital Medical University(“our hospital”for short), and to provide reference for drug management in public hospitals under the new situation. Methods The main measures of drug cost management in our hospital were introduced,and the total amount of outpatient drugs, inpatient drugs, adjuvant drugs, total number of outpatients and discharged patients were analyzed statistically from 2016 to 2019. The proportion of average outpatient drug cost, average inpatient drug cost and adjuvant drugs cost in the four years was compared, and the management effectiveness was comprehensively evaluated.Results From 2016 to 2019, the average drug cost per outpatient in our hospital gradually decreased, and decreased by4.86%, 1.67% and 9.20% in 2017, 2018 and 2019 compared with the previous year(P<0.05). The average drug cost per hospitalization decreased year by year, and decreased by 5.31%, 0.05% and 1.65% in 2017, 2018 and 2019, respectively,compared with the previous year(P<0.05). The expense proportion of auxiliary drugs was decreased year by year, and decreased by 18.45%, 24.82% and 5.83% in 2017, 2018 and 2019 compared with the previous year. Conclusion Through multi-department co-management in our hospital, a new drug expense management mode is formed, which can be summed up as “budget leading, performance ending, to departments, overall management”. The management effectively reduces the average drug expenses per outpatient and inpatient as well as the expense proportion of auxiliary drugs, and improves the level of rational drug use in the hospital.

关 键 词：药事管理 次均药品费用 合理用药 绩效考核 

分 类 号：R197.3[医药卫生—卫生事业管理]