静脉药物调配中心新生儿药品区块化收费方式初探  

Preliminary study on the block-based charging model for neonatal medication in pharmacy intravenous admixture service

作　　者：部娜[1] 王丽[1] 严晶晶[1] 全嘉南 朱尧 黄伟 郑晓玲[1] Bu Na;Wang Li;Yan Jingjing;Quan Jianan;Zhu Yao;Huang Wei;Zheng Xiaoling(Department of Pharmacy,Women′s Hospital,School of Medicine,Zhejiang University,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属妇产科医院药剂科,杭州310006

出　　处：《中华医院管理杂志》2023年第3期239-242,共4页Chinese Journal of Hospital Administration

摘　　要：目的:探索静脉药物调配中心(PIVAS)集中调配的新生儿药品采用区块化收费方式,分析该收费方式对院内药品节余、患儿住院药品费用的影响,为集中调配药品合理收费方式提供参考。方法:根据医院PIVAS集中调配的新生儿药品节余数量和金额,结合患儿均次医嘱剂量和均次用药人数拟定区块化收费的药品种类和方案;以月均药品节余数量和金额、患儿均次药品收费数量和日均药品费用、相关药品的不良事件为指标,考察药品区块化收费方式实施效果。结果:实施药品区块化收费的药品14个,其中抗生素类药品4个,普通输液类药品2个,肠外营养液类药品8个。区块化收费方式实行后,月均药品节余数量由(5 047±541)瓶/袋/支降至(1 856±225)瓶/袋/支,月均节余金额由(65 811±10 265)元降至(20 659±6 002)元;患儿均次药品收费数量显著降低,降幅为39.2%~90.1%,住院患儿日均药品费用及日均抗菌药品费用均显著降低( P<0.05)。区块化收费方式实施后,未发生相关药品不良事件。 结论:药品集中调配的区块化收费方式,可以显著提高药品利用率,减少药品节余,降低患儿住院药品费用,减轻患儿家庭经济负担。ObjectiveTo explore the block-based charging method for centralized dispensing of neonatal drugs in pharmacy intravenous admixture service(PIVAS),analyze its effect on drug savings and inpatient drug cost,so as to provide the reference for the appropriate charging method of neonatal drugs.MethodsAccording to the balance quantity and amount of neonatal intravenous drugs that were centrally allocated by the PIVAS of our hospital,refer to the doctor′s orders,the dosage per dose as well as the number of patients per dose were analyzed,then the drug types and plans for block-based charging were formulated.Before and after the implementation of the plan,the monthly average drug balance quantity and amount,the average number of drug charges for the neonates,the average daily drug cost,and the adverse events of related drugs were used as the indicators to be investigated to clarify the implementation effect of the block-based charging mothod.ResultsFourteen medicines were charged by block-based,including 4 antibiotics,2 ordinary infusion preparations,and 8 parenteral nutrition solution preparations.The monthly average drug balance quantity was reduced from 5047±541 to 1856±225,and the monthly average balance amount was reduced from 65811±10265 yuan to 20659±6002 yuan.The average drug dosage for children in the trial drug was significantly reduced with a decrease range of 39.2%to 90.1%.Both the inpatient daily drug cost of neonatus and the daily average antibacterial drug cost was decreased.During the centralized dispensing of neonatal drugs,no related adverse drug events occurred.ConclusionsThe block-based charging method of centralized drug distribution can improve the utilization rate of drugs,reduce drug waste,reduce the cost of inpatient medicines the financial burden on children′s families,which is worthy of further promotion and implementation.

关 键 词：药物调剂 静脉药物调配中心 新生儿 区块化收费方式 住院药品费用 药品节余 

分 类 号：R95[医药卫生—药学]