浅谈药剂科对医院不合理用药的药学干预
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摘要
目的了解泾县医院药剂科对不合理用药管理的药学干预效果。方法对泾县医院2014年实施药学干预前后的药品使用数据进行比较分析,对比管理前后抗菌药物等使用指标变化,评价管理效果。结果通过对不合理用药的持续干预,该院药品使用情况更加合理。住院病人次均药品费用三年间下降581元,下降幅度30.8%,辅助用药总费用三年间下降至1 030.1万元,辅助用药总费用占比下降15.11%,抗菌药物临床使用指标逐步优化。结论通过药剂科对医院不合理用药的持续性干预,有效减少了病人在辅助用药上的支出,抑制了临床抗菌药物不合理使用行为。为医院临床路径工作的有序开展提供了药学支持,为新一轮公立医院医疗改革的有效落实提供了合理用药的有利环境。
Objective To explore the effect of pharmaceutical intervention on irrational drug use management in the pharmacy department of Jingxian Hospital of Anhui Province.Methods A comparative analysis was made of drug use data before and after pharmaceutical intervention implemented in Jingxian Hospital in 2014,and the management effect was evaluated by comparing the use indexes of antibacterial drugs before and after management.Results Through continuous intervention of irrational drug use in hospital,the drug use is more reasonable.Per-visit inpatient drug expense fell by 581 yuan in three years with a decrease rate of 30.8%.The total cost of adjuvant drugs decreased by 1 030.1 million yuan in three years,and the proportion of total cost of auxiliary drugs decreased by 15.11%.The clinical indexes of antibacterial were gradually optimized.Conclusions Persistent intervention for irrational use of drug in hospital effectively reduces the cost spent on the adjuvant drugs and inhibits the irrational use of clinical antibacterial.It not only provides pharmaceutical support for effective implementation of the hospital clinical pathway work,but also creates a favorable environment of rational drug use for a new round of reform in public hospitals.
Objective To explore the effect of pharmaceutical intervention on irrational drug use management in the pharmacy department of Jingxian Hospital of Anhui Province.Methods A comparative analysis was made of drug use data before and after pharmaceutical intervention implemented in Jingxian Hospital in 2014,and the management effect was evaluated by comparing the use indexes of antibacterial drugs before and after management.Results Through continuous intervention of irrational drug use in hospital,the drug use is more reasonable.Per-visit inpatient drug expense fell by 581 yuan in three years with a decrease rate of 30.8%.The total cost of adjuvant drugs decreased by 1 030.1 million yuan in three years,and the proportion of total cost of auxiliary drugs decreased by 15.11%.The clinical indexes of antibacterial were gradually optimized.Conclusions Persistent intervention for irrational use of drug in hospital effectively reduces the cost spent on the adjuvant drugs and inhibits the irrational use of clinical antibacterial.It not only provides pharmaceutical support for effective implementation of the hospital clinical pathway work,but also creates a favorable environment of rational drug use for a new round of reform in public hospitals.
引文
[1] 国家卫生和计划生育委员会.关于印发控制公立医院医疗费用不合理增长的若干意见的通知[EB/OL].(2015-11-06)[2017-02-24].http://www.nhfpc.gov.cn/tigs/s3577/201511/0038da2bf8fe43d69511fb675e205d37.shtml.
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[5] 中华医学会眼科学分会白内障和人工晶状体学组.关于白内障围手术期预防感染措施规范化的专家建议(2013)[J].中华眼科杂志,2013,49(1):76-78.
[6] 方维军,张艳丽,袁曼.临床药师对临床不合理用药事先干预模式的探索[J].安徽医药,2016,20(11):2173-2176.
[7] 安徽省卫生和计划生育委员会.关于进一步加强安徽省医疗机构静脉输液管理的通知(卫医秘[2015]279号)[EB/OL].(2015-07-24)[2017-02-24].http://www.ahwjw.gov.cn/wjwxxgk/infodetail143.html
[8] 中华人民共和国人力资源和社会保障部.关于印发国家基本医疗保险、工伤保险和生育保险药品目录(2017年版)的通知(人社部发[2017]15号)[EB/OL].(2017-02-23)[2017-02-24].http://www.mohrss.gov.cn/SYrlzyhshbzb/SYgundongxinwen/201702/t20170223_266775.html
[9] 甘泉,史录文.基本医疗保险与药物经济学的关系[J].中国临床药理学杂志,2007,23(1):73-75.
[10] 刘翌,闫峻峰.省级药事质控中心在重点监控药品监管中的作用[J].中国药房,2017,28(4):458-462.
[2] The United States National Library of Medicine.2011 MeSH/MARC[DB/OL].[2017-02-24].https://www.ncbi.nlm.nih.gov/mesh/68000277.
[3] 陈新谦,金有豫,汤光.新编药物学[M].17版.北京:人民卫生出版社,2011:11-13.
[4] 卫生部,国家中医药管理局,总后卫生部.卫生部办公厅关于抗菌药物临床应用管理有关问题的通知[Z].2009-03-23.
[5] 中华医学会眼科学分会白内障和人工晶状体学组.关于白内障围手术期预防感染措施规范化的专家建议(2013)[J].中华眼科杂志,2013,49(1):76-78.
[6] 方维军,张艳丽,袁曼.临床药师对临床不合理用药事先干预模式的探索[J].安徽医药,2016,20(11):2173-2176.
[7] 安徽省卫生和计划生育委员会.关于进一步加强安徽省医疗机构静脉输液管理的通知(卫医秘[2015]279号)[EB/OL].(2015-07-24)[2017-02-24].http://www.ahwjw.gov.cn/wjwxxgk/infodetail143.html
[8] 中华人民共和国人力资源和社会保障部.关于印发国家基本医疗保险、工伤保险和生育保险药品目录(2017年版)的通知(人社部发[2017]15号)[EB/OL].(2017-02-23)[2017-02-24].http://www.mohrss.gov.cn/SYrlzyhshbzb/SYgundongxinwen/201702/t20170223_266775.html
[9] 甘泉,史录文.基本医疗保险与药物经济学的关系[J].中国临床药理学杂志,2007,23(1):73-75.
[10] 刘翌,闫峻峰.省级药事质控中心在重点监控药品监管中的作用[J].中国药房,2017,28(4):458-462.