医保住院患者合理用药分析及药师干预效果比较
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摘要
目的提高医保住院患者用药合理性,减少医保拒付情况。方法对比药师临床干预前后医保住院患者的临床用药资料(干预前4 124份,干预后6 104份),分析住院时长、药占比、医保自付费用。结果干预后,患者住院时长由干预前的(7. 20±0. 24) d缩短为(5. 73±0. 10)d,药占比由干预前的(38. 48±0. 70)%降为(29. 05±0. 10)%,自付费用比例由干预前的(30. 56±0. 40)%降为(27. 69±0. 40)%,差异均有统计学意义(P <0. 05)。结论通过对医保住院患者的用药分析,有针对性地采取合理的临床干预措施,提高了医保患者的用药合理性,减少了医保拒付次数和金额,减轻了患者的经济负担。
Objective To improve the rational drug use in medical insurance inpatients and reduce the protest in medical insurance.Methods The clinical data of the medical insurance inpatients before and after the clinical intervention were compared( before the clinical intervention: 4 124 copies,after the clinical intervention: 6 104 copies),and the hospitalization days,proportion of inpatient drugs and self-paid expenses in medical insurance were analyzed. Results After intervention,the length of hospitalization was shortened from( 7. 20 ± 0. 24) d to( 5. 73 ± 0. 10) d,the proportion of drugs decreased from( 38. 48 ± 0. 70) % to( 29. 05 ± 0. 10) %,and the proportion of self-paid expenses decreased from( 30. 56 ± 0. 40) % to( 27. 69 ± 0. 40) %,the differences were statistically significant( P < 0. 05).Conclusion Through the analysis of medical records of medical insurance inpatients,reasonable clinical intervention measures can improve the rational drug use for medical insurance patients,reduce the times and amount of protest in medical insurance,and also reduce the economic burden of patients.
Objective To improve the rational drug use in medical insurance inpatients and reduce the protest in medical insurance.Methods The clinical data of the medical insurance inpatients before and after the clinical intervention were compared( before the clinical intervention: 4 124 copies,after the clinical intervention: 6 104 copies),and the hospitalization days,proportion of inpatient drugs and self-paid expenses in medical insurance were analyzed. Results After intervention,the length of hospitalization was shortened from( 7. 20 ± 0. 24) d to( 5. 73 ± 0. 10) d,the proportion of drugs decreased from( 38. 48 ± 0. 70) % to( 29. 05 ± 0. 10) %,and the proportion of self-paid expenses decreased from( 30. 56 ± 0. 40) % to( 27. 69 ± 0. 40) %,the differences were statistically significant( P < 0. 05).Conclusion Through the analysis of medical records of medical insurance inpatients,reasonable clinical intervention measures can improve the rational drug use for medical insurance patients,reduce the times and amount of protest in medical insurance,and also reduce the economic burden of patients.
引文
[1]张趁.我院2012-2013年度住院病人抗肿瘤药物使用情况分析[J].天津药学,2014,26(5):44-46.
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[11]胡大洋,万彬,程向前,等. 6家医院执行《江苏省医保药品目录》效果研究[J].中国医院管理,2012,32(7):59-61.
[12]管玺,顾志杰,吴华平. PDCA循环在医院合理用药医保管理中如何应用[J].医保园地,2017(3):50-51.
[13]蔡木禹,林朝仙,李艳萍,等.医保费用定额支出干预对临床合理用药的影响[J].中国药房,2014,25(2):104-106.
[14]赵宁志,高茗,茅建华,等.多元激励机制在医院管理中的应用[J].东南国防医药,2010,12(6):564-566.
[15]黄万育.药品的规范配置使用与临床合理用药[J].中国药物与临床,2012,12(12):1649-1650.
[16]傅全威,车兆畅,赵昕,等.医保患者肿瘤化疗单病种超支原因分析及改进措施[J].航空航天医学杂志,2012,23(3):370-371.
[17]赵宁志,纪永章,王家振,等.精细化管理在医院合理用药中应用的探讨[J].人民军医,2014,57(5):564-565.
[18]高茗,赵宁志.医院合理应用抗菌药物的建议[J].人民军医,2007,50(9):571.
[2]黄秀芹,孔旭辉.基本药物自付比例调整对某院消化内科“医保”支付费用的影响分析[J].中国药房,2013,24(48):4576-4578.
[3]付文鹏,王迦雯,吴燕,等. 2012年-2014年某院门诊医保处方合理性分析及整改措施探讨[J].实用医药杂志,2017,34(6):574-575.
[4]陈敏玲,张顺国,李岚.上海地区2007~2009年105家医院“医保”甲类药物的应用情况分析[J].中国药房,2010,21(48):4565-4567.
[5]刘颖姝.我院医保高血压患者用药和医保拒付情况分析[J].中国医药导报,2012,9(31):123-125.
[6]乔岭梅,文光慧.军队医院的医保培训现状及对策分析[J].解放军预防医学杂志,2014,32(2):185-186.
[7]闫小萍,董一颍,杨宇,等. 17 838例医保病人住院费用的构成分析[J].中国病案,2011,12(4):51-52.
[8]王建平,刘茵,杨云,等.我国医疗费用总体构成情况分析及医改建议[J].中国药房,2014,25(17):1555-1557.
[9]赵宁志,赵伯诚,高茗,等.精细化管理在缩短平均住院日中应用的探讨[J].人民军医,2014,57(5):562-563.
[10]冀文斌.医保专项检查中对1 215份医保住院病历存在问题分析与对策[J].中国卫生产业,2012(23):171.
[11]胡大洋,万彬,程向前,等. 6家医院执行《江苏省医保药品目录》效果研究[J].中国医院管理,2012,32(7):59-61.
[12]管玺,顾志杰,吴华平. PDCA循环在医院合理用药医保管理中如何应用[J].医保园地,2017(3):50-51.
[13]蔡木禹,林朝仙,李艳萍,等.医保费用定额支出干预对临床合理用药的影响[J].中国药房,2014,25(2):104-106.
[14]赵宁志,高茗,茅建华,等.多元激励机制在医院管理中的应用[J].东南国防医药,2010,12(6):564-566.
[15]黄万育.药品的规范配置使用与临床合理用药[J].中国药物与临床,2012,12(12):1649-1650.
[16]傅全威,车兆畅,赵昕,等.医保患者肿瘤化疗单病种超支原因分析及改进措施[J].航空航天医学杂志,2012,23(3):370-371.
[17]赵宁志,纪永章,王家振,等.精细化管理在医院合理用药中应用的探讨[J].人民军医,2014,57(5):564-565.
[18]高茗,赵宁志.医院合理应用抗菌药物的建议[J].人民军医,2007,50(9):571.