Research on improving the management efficiency of medical insurance restricted medication in primary hospitals based on independent research and development of rational medication management system
Objective To investigate the efficiency of independent research and development of rational medication management system combined with pharmaceutical administration intervention on improving the management of medical insurance restricted medication in primary hospitals,so as to provide reference for the majority of primary hospitals.Methods In September 2022,an architecture based on hospital information system(HIS)was launched by Zhongshan Nanlang Hospital,and a rational medication management system with prescription extraction,online review,medical insurance restricted medication prescription information reminder and interception functions was independently developed.At the same time,multi-dimensional pharmaceutical management measures such as clinical education,catalogue maintenance and prescription special comment were implemented to intervene.After intervention,the payment coincidence rate,the penalty amount of over-limit payment,the proportion of drugs,and the average drug cost of hospitalization from September to December,2022 were compared with September to December,2021.Results The coincidence rate of medical insurance restricted medication payment was increased from 63.52％to 80.95％.In the prescriptions drawn from the medical insurance special inspection site,the amount of medical insurance restricted medication deduction amount decreased from 80 300 yuan to 25 799 yuan,a year-on-year decrease of 67.87％.The proportion of medical insurance restricted medication in the whole hospital decreased from 6％before intervention to 4％.The average drug cost per hospitalization for medical insurance restricted medication decreased from 17 316.59 yuan to 13 733.18 yuan.The proportion of drugs in the hospital decreased from 23.22％before intervention to 18.78％.Conclusion Based on independent research and development of rational medication management system and multi-dimensional pharmaceutical management intervention,it can improve the management efficiency of medical insurance restricted medication in primary hospitals,which can be used as a reference for the majority of primary hospitals.
Independent research and developmentPharmaceutical management interventionMedical insurance restricted medicationManagement efficiency
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