Effect of Pharmaceutical Administration Intervention Based on DRG Payment on the Rational Use of Intravenous Infusion in Primary Hospitals
Objective To promote the rational use of intravenous infusion in hospitals.Methods The pharmaceutical administration intervention was conducted based on the diagnosis related groups(DRG)payment from October to December 2021.The intervention measures included strengthening publicity and education,sorting out the types of intravenous infusion and disease spectrum,formulating corresponding clinical pathways for diseases,adding special review for infusion prescriptions,incorporating irrational prescribing into performance assessment and implementing information system control.The patients'data of the outpatient/emergency and inpatient departments of the hospital from January to September 2021(before pharmaceutical administration intervention)and from January to September 2022(after pharmaceutical administration intervention)were extracted by the hospital information system and rational drug use software.The intravenous infusion-related indicators of all prescriptions and prescriptions containing antibiotics,traditional Chinese medicine injections,hormones(or adjuvant drugs)and DRG-related pharmaceutical indicators of inpatients before and after intervention were analyzed.Results Compared with those before intervention,the overall use rate of intravenous infusion and use rates of different intravenous infusions(calculated by person-times and quantity of prescriptions)in outpatient/emergency patients significantly decreased after intervention(P<0.01),and the use rate of intravenous infusion(calculated by person-times)in inpatients significantly decreased except for antibiotic infusion(P<0.01);the drug costs in outpatient/emergency patients and inpatients decreased to varying degrees;the return and modification rate of prescriptions in outpatient/emergency patients significantly increased from 2.41%to 3.54%(P<0.01);the overall satisfaction degree of patients with service significantly increased from 73.20%to 94.20%(P<0.01).Compared with those before intervention,the inpatients'DRG total weight,case-mix index(CMI)and the proportion of essential drug costs all increased after intervention;the inpatients'charge consumption index,time consumption index and average cost per time all decreased;the inpatients'mortality rate,structure ratio of intravenous infusion,adjuvant-drug structure ratio,average drug cost per time and average adjuvant-drug cost per time all decreased.Conclusion This pharmaceutical administration mode significantly decreases the use rate of intravenous infusion,promotes the rational drug use in the hospital,decreases patients'medical costs,enhances their satisfaction,and improves the overall medical service level of the hospital.
DRG paymentprimary hospitalpharmaceutical administrationuse rate of intravenous infusionrational drug use
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