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基于疾病诊断相关分组支付下构建精细化药学服务新模式

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本文旨在探索按疾病诊断相关分组(DRG)支付方式改革精细化药学服务新模式方法。福建医科大学附属协和医院于 2020 年 3 月 15 日正式实施起DRG支付方式改革,对其下构建药学服务方法进行探索。分析制定药学版临床路径 400 多个,实现临床用药的精细化专科管理,优化医院药品目录,描述建立"院内+科内"用药联动管理模式,推进综合性医院药品合理应用的联合监管的创新方法,从原病区质控药师"0"到现在的质控药师全院覆盖 100%。通过阐述以合理用药为样板,促进药物经济学在医院管理中的应用,从而推进DRG医保支付方式改革的实施,协助医院绩效考核指标的达成,体现药师价值,为基于药学服务的药学绩效分配提供依据。大数据下DRG支付改革构建药学服务新模式,提升医疗服务质量,控制不合理药品费用,保障患者健康权益的目标。大数据下在DRG支付改革构建药学服务新模式下,推荐出最具有性价比的用药方案,规范临床路径中的药品选择,降低药品不良反应的发生,控制患者用药成本,为肿瘤规范化诊疗工作开展研究,更是为了全学科推广规范化、同质化诊疗开展工作。
Construct a new model of refined pharmaceutical care based on payment of diagnosis related groups
The purpose of this paper is to explore a new model of pharmaceutical care based on diagnosis related groups(DRG)payment reform.The Union Medical College Hospital,Fujian Medical University officially implemented the reform of DRG payment method on March 15,2020,and explored the method of constructing pharmaceutical care under it.Over 400 clinical pathways specific to pharmacy were analyzed and developed to achieve refined management of clinical drug use in specialty departments,optimize the hospital drug catalog,and establish an"in-hospital+in-department"drug linkage management model.This innovative joint supervision approach for rational drug use in general hospitals progressed from having"0"quality control pharmacists in wards to covering 100%of the hospital.By illustrating rational drug use as a mod-el,the application of pharmacoeconomics in hospital management is promoted,thereby advancing the implementation of the DRG medical insurance payment reform,assisting in achieving hospital performance appraisal indicators,reflecting the value of pharmacists,and providing a basis for pharmaceutical performance distribution based on pharmaceutical services.The DRG payment reform under big data constructs a new model of pharmaceutical services,improves the quality of medical services,controls unreasonable drug costs,and protects patients'health rights.Under big data,the new model of pharmaceu-tical services constructed under the DRG payment reform recommends the most cost-effective drug regimens,standardizes drug selection in clinical pathways,reduces adverse drug reactions,controls patient medication costs,and facilitates research for standardized diagnosis and treatment of tumors.Furthermore,it promotes the standardized and homogeneous diagnosis and treatment across all disciplines.

Diagnosis related groupsRational drug usePharmaceutical careRefined

郑碧容、周海梅

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福建医科大学附属协和医院药学部,福建福州 350001

按疾病诊断相关分组 合理用药 药学服务 精细化

2024

中国当代医药
中国保健协会 当代创新(北京)医药科学研究院

中国当代医药

影响因子:1.215
ISSN:1674-4721
年,卷(期):2024.31(25)