药师主导的合理用药管控体系对医院药品费用管控和医疗质量提升的效果分析
Effect analysis of a pharmacist-led rational medication management program on cost control and quality improvement in the hospital
刘媛 1徐嵘 1简桂花 2赵新才 1胡承方 3狄建忠 4郭澄 1张剑萍 1魏伟5
作者信息
- 1. 上海交通大学医学院附属第六人民医院药剂科,上海 200233
- 2. 上海交通大学医学院附属第六人民医院肾内科,上海 200233
- 3. 上海交通大学医学院附属第六人民医院医务处,上海 200233
- 4. 上海交通大学医学院附属第六人民医院院长办公室,上海 200233
- 5. 上海交通大学医学院附属第六人民医院综合绩效管理处,上海 200233
- 折叠
摘要
目的 探索建立药师主导的合理用药管控体系并评价其对医院药品费用管控和医疗质量提升的效果.方法 由药剂科主导,成立合理用药管控小组,运用PDCA循环管理工具,建立临床药师主导的合理用药管控体系.对比分析采用合理用药干预体系管控前后门诊和住院的次均药费、国家基本药物使用金额占比(基药占比)、处方或医嘱不合理率和住院患者输液率等指标的变化.结果 门诊、住院次均药品费用的平均值分别由2022年1至6月的238.48元和4 576.76元,降低到2023年1至6月的179.64元(较干预前降低24.67％)和3 412.61元(较干预前降低25.44％);干预后,基药占比指标呈现持续上升趋势,平均值由36.63％上升至38.82％.在全院动态监控药品合理性使用评价方面,处方或医嘱不合理率由36.47％下降到15.72％,住院患者输液率从82.97％下降到80.81％,差异均具有统计学意义(P＜0.001).结论 通过合理用药干预,门诊、住院次均药费明显降低,药品不合理使用情况明显改善,提示药师主导的合理用药管控措施促进了临床药品合理应用,降低了医药费用.
Abstract
AIM To incorporate a pharmacist-led rational medication management program and evaluate its impact on cost control and quality improvement in the hospital.METHODS A rational medication management committee was established under the leadership of the pharmacy department.Clinical pharmacists in the committee managed rational drug use based on the PDCA cycle strategy.Changes in the pharmaceutical spending per capita,the proportion of national essential drugs spending,the rate of irrational medical orders/medical devices,and the rate of inpatient infusion and other indicators were compared before and after the program implementation.RESULTS On average,the outpatient and inpatient pharmaceutical spending per capita decreased from 238.48 yuan and 4 576.76 yuan in January-June 2022 to 179.64 yuan(a 24.67％decrease compared to before the program's implementation)and 3 412.61 yuan(a 25.44％decrease compared to before the program's implementation)in January-June 2023,respectively.After establishing the rational medication management program,the proportion of national essential drugs spending continuously increased,from 36.63％to 38.82％.In addition,the hospital-wide dynamic monitoring of rational drug usage demonstrated that the rate of irrational medical prescriptions decreased from 36.47％to 15.72％on average.The rate of inpatient infusion decreased from 82.97％to 80.81％.All the results were statistically significant(P＜0.001).CONCLUSION Through the pharmacist-led rational medication management program,the outpatient and inpatient pharmaceutical spending per capita is significantly reduced in our hospital,and inappropriate drug use is significantly decreased,suggesting that the pharmacist-led rational medication management program promoted the rational usage of clinical medications and reduced hospital costs.
关键词
合理用药/次均药费/动态监控Key words
rational drug use/pharmaceutical spending per capita/dynamic monitoring引用本文复制引用
基金项目
上海申康医院发展中心管理研究项目(2023SKMR-19)
上海市医院协会临床药事管理专业委员会研究专项(YS2021001)
出版年
2024
国家科技期刊平台
NSTL
万方数据