Application Effect of Drug Therapy Pathway Management in Rational Prophylactic Use of Recombinant Human Erythropoietin During Orthopedic Perioperative Period Under CHS-DRG Payment
OBJECTIVE:To explore the application effect of pathway-based management of recombinant human erythropoietin(rhEPO)injection during orthopedic perioperative period in orthopedics under the reform of China Healthcare Security Diagnosis Related Groups(CHS-DRG)payment system.METHODS:Delphi method was employed,and two rounds of plan-do-check-act(PDCA)cycles were conducted to formulate the drug therapy pathway for rhEPO.Patients hospitalized in orthopedics of the hospital from Mar.to Jul.2022 were extracted as the pre-management group,and patients from Mar.to Jul.2023 were extracted as the post-management group.Eight DRG categories with the highest use rate of rhEPO were selected,and the improvement degree of benefit indicators(average hospitalization cost,average drug cost,average length of stay,rational use rate of rhEPO,blood transfusion rate)before and after management was compared.RESULTS:Compared with before management,the average hospitalization cost of orthopedic inpatients after management decreased from 58 829.79 yuan to 48 259.29 yuan(P<0.05),the average drug cost decreased from 3 311.23 yuan to 2 987.52 yuan(P<0.05),the average length of stay reduced from 10.1 d to 8.05 d(P<0.01),with statistically significant differences.The rational use rate of rhEPO increased from 26.27%(62/236)to 91.54%(238/260),blood transfusion rate decreased from 34.66%(165/476)to 25.57%(169/661).CONCLUSIONS:By implementing pathway-based management and formulating standardized drug protocols,resource allocation has been optimized,medical quality has been improved,and the benefit indicators of DRG categories have been significantly enhanced.
Diagnosis related groupsPrecision managementDrug therapy pathwayOrthopedicsRecombinant human erythropoietinBlood management
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维普
