按疾病分组付费为主的综合管控模式在降低住院药占比中的干预效果分析
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摘要
目的构建按疾病分组(DRGs)付费为主的综合管控模式,降低医院住院药占比,促进医保药品合理使用。方法实施临床药师参与下的DRGs付费、结合三大类药物(辅助用药、中药注射剂和质子泵抑制剂)重点监测等措施的综合管控模式,比较管控前阶段(2017年2-4月)、管控第一阶段(2017年5-7月)、管控第二阶段(2017年8-10月)和管控第三阶段(2017年11月-2018年1月)的住院患者人均药费、人均住院费用、药占比、三大类药物金额及占比。结果住院患者次均药费、人均住院费用、药占比、三大类药物使用金额和使用金额占比均下降。结论以DRGs付费为主的综合管控模式在降低住院药占比中能发挥重要作用,促进了医保药品的合理使用。
Objective To reduce the proportion of hospital medications and promote the rational use of medical insurance products, and to establish a comprehensive management and control model for diagnosis related groups(DRGs) and emphasis on major drugs. Methods A comprehensive management focusing on payment by DRGs and monitoring of 3 major drugs(adjuvant drugs, Chinese medicine injections, and proton pump inhibitors) was implemented with the participation of clinical pharmacists. We compared per capita drug cost,per capita hospitalization cost, proportion of medicine, and the proportion of the 3 major types of drugs for inpatients in the pre-control phase(February-April 2017), the first control phase(May-July 2017), the second control phase(August-October 2017), and the third control phase(November 2017-January 2018).Results The proportion of inpatients' average cost of medicine, per capita hospitalization, the amount and proportion of the 3 major types of drugs were all decreased. Conclusion The management interventions based on payment by DRGs play an important role in reducing drug cost and promoting rational use of drugs.
Objective To reduce the proportion of hospital medications and promote the rational use of medical insurance products, and to establish a comprehensive management and control model for diagnosis related groups(DRGs) and emphasis on major drugs. Methods A comprehensive management focusing on payment by DRGs and monitoring of 3 major drugs(adjuvant drugs, Chinese medicine injections, and proton pump inhibitors) was implemented with the participation of clinical pharmacists. We compared per capita drug cost,per capita hospitalization cost, proportion of medicine, and the proportion of the 3 major types of drugs for inpatients in the pre-control phase(February-April 2017), the first control phase(May-July 2017), the second control phase(August-October 2017), and the third control phase(November 2017-January 2018).Results The proportion of inpatients' average cost of medicine, per capita hospitalization, the amount and proportion of the 3 major types of drugs were all decreased. Conclusion The management interventions based on payment by DRGs play an important role in reducing drug cost and promoting rational use of drugs.
引文
[1]侯继秋,王冬雪,黄玉鑫,等.探讨临床药师在降低药占比的药学服务模式及效果评价[J].中国医院药学杂志,2016,36(23):2119-2122.
[2]黄利娟,查君敬,毛以成,等.基于DRGs组合方式制定子宫平滑肌瘤患者住院费用标准的分析[J].中国病案,2017,18(6):64-66.
[3]佟黎莉,任苒.医疗保险患者三个病种住院费用的影响因素分析[J].中华医院管理杂志,2005,21(11):766-768.
[4]李仁琼,王雅玲,雷继红. DRGs-PPS相关研究综述[J].中国病案,2014,15(11):35-37.
[5]刘羿,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.
[6]韩凤昭,李振知,杨文华. DRGs-PPS下的临床药师参与股骨颈骨折临床路径的实施效果[J].中国药房,2017,28(33):3281-3284.
[2]黄利娟,查君敬,毛以成,等.基于DRGs组合方式制定子宫平滑肌瘤患者住院费用标准的分析[J].中国病案,2017,18(6):64-66.
[3]佟黎莉,任苒.医疗保险患者三个病种住院费用的影响因素分析[J].中华医院管理杂志,2005,21(11):766-768.
[4]李仁琼,王雅玲,雷继红. DRGs-PPS相关研究综述[J].中国病案,2014,15(11):35-37.
[5]刘羿,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.
[6]韩凤昭,李振知,杨文华. DRGs-PPS下的临床药师参与股骨颈骨折临床路径的实施效果[J].中国药房,2017,28(33):3281-3284.