基于绩效考核的肿瘤医院药物合理使用情况分析  

Analysis of rational drug use in the cancer hospital based on performance evaluation

作　　者：吕永强[1] 严虹霞[2] Lyu Yongqiang;Yan Hongxia(Department of Operation Management,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Pharmacy,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院运营管理部,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院药学部,太原030013

出　　处：《肿瘤研究与临床》2024年第6期459-462,共4页Cancer Research and Clinic

基　　金：山西省科技战略研究专项(202204031401160)。

摘　　要：目的探讨绩效考核对肿瘤医院临床药物合理使用的影响。方法由山西省肿瘤医院合理用药绩效考核组结合2017年至2019年各指标的平均值,确定各考核指标的目标值,并赋相应的绩效分值,建立合理用药绩效考核体系。回顾性分析2019年1月至2022年12月山西省肿瘤医院国家基本药物使用占比、抗菌药物使用强度、辅助用药使用金额占比及各类药物在使用过程中的药品遴选、药品用量、给药途径、给药频率、给药疗程、溶媒或溶媒用量、有指征过度用药、超说明书用药、配伍禁忌等指标。结果住院患者国家基本药物使用率从2019年的20.17%提高到2022年的57.30%;抗菌药物使用强度由2019年的12.07限定日剂量数(DDDs)降至2022年的12.00 DDDs,且呈逐年下降趋势;辅助用药使用金额占比由2019年的2.60%降至2022年的0.01%。2019年至2022年各项考核指标不合理率均逐年下降,其中药品遴选不适宜率由39.20%降至5.30%,药品用量不适宜率由8.80%降至1.10%,给药途径不适宜率由4.70%降至0.10%,给药频率不适宜率由11.70%降至1.10%,给药疗程不适宜率由10.10%降至0.90%,溶媒或溶媒用量不适宜率由21.10%降至7.30%,有指征过度用药率由15.30%降至0.70%,超说明书用药率由2.60%降至0.10%,配伍禁忌率由0.20%降至0。结论精细化的合理用药绩效考核体系可以有效控制肿瘤医院药品费用,推动临床合理用药。Objective To explore the impact of performance evaluation on the rational use of clinical drugs in the cancer hospital.Methods The rational drug use performance evaluation group of Shanxi Province Cancer Hospital combined the average value of each index from 2017 to 2019 to determine the target value of each evaluation index,and assigned the corresponding performance score and established the rational drug use performance evaluation system.The proportion of national essential drug use,the intensity of antimicrobial drug use,the proportion of the amount of adjuvant drug use and the drug selection in the process of drug use,drug dosage,administration route,administration frequency,administration course,solvent or solvent dosage,overuse of drug with indication,drug use beyond the instruction,and contraindication to the dispensing of drug,and other indicators from January 2019 to December 2022 in Shanxi Province Cancer Hospital were retrospectively analyzed.Results The national essential drug use rate in hospitalized patients increased from 20.17% in 2019 to 57.30% in 2022;the intensity of antimicrobial drug use decreased from 12.07 number of defined daily doses(DDDs)in 2019 to 12.00 DDDs in 2022,and showed a decreasing trend year by year;the percentage of the amount of adjuvant drug use decreased from 2.60% in 2019 to 0.01% in 2022.From 2019 to 2022,the unreasonable rate of all assessment indicators decreased year by year,of which the rate of inappropriate drug selection decreased from 39.20% to 5.30%,the rate of inappropriate drug dosage decreased from 8.80% to 1.10%,the rate of inappropriate administration route decreased from 4.70% to 0.10%,the rate of inappropriate administration frequency decreased from 11.70%to 1.10%,the rate of inappropriate administration course decreased from 10.10% to 0.90%,the rate of inappropriate solvent or solvent dosage decreased from 21.10% to 7.30%,the rate of overuse of drug with indication decreased from 15.30% to 0.70%,the rate of drug use beyond the instruction decreased from 2.

关 键 词：医院管理 肿瘤 药剂学管理 药剂师 绩效考核 

分 类 号：R95[医药卫生—药学]