三级公立医院绩效考核背景下药品绩效考核体系的建立与应用

Establishment and application of a drug performance appraisal system based on the performance appraisal for tertiary public hospitals

三级公立医院绩效考核为公立医院的合理用药管理提供了抓手。自2021年10月起, Z医院结合医院实际情况, 基于三级公立医院绩效考核中对合理用药的相关要求, 建立了包含加权门诊人均药品费用、加权住院人均药品费用、药品合理使用率和抗菌药物使用强度4项指标的药品绩效考核体系, 通过将医院用药目录中的所有药品分为A、B、C 3类并赋予不同权重, 以及合理设定各指标目标值的方法引导临床科室合理用药。Z医院药占比由2020年的28.75%降至2022年的25.44%, 医疗服务收入占比由22.97%升至28.40%, 门诊人均药品费用由170元降至166元, 住院人均药品费用由7 318元降至5 983元。与2021年9月相比, 2022年9月医院药品合理使用率达到100%的科室数量由11个增至16个, 抗菌药物使用强度降低35.84%。该药品绩效考核体系的实施在一定程度上优化了医院的收入结构, 控制了药品费用的增长, 促进了药物的合理使用, 可为三级公立医院的合理用药管理提供参考。

The performance appraisal for tertiary public hospitals provides means for the rational management of drug use in public hospitals.Starting from October 2021,Hospital Z had established a drug performance appraisal system based on the relevant requirements for rational drug use in the performance appraisal for tertiary public hospitals,in view of the actual situation.The system included four indexes:weighted outpatient per capita drug cost,weighted inpatient per capita drug cost,rational drug use rate,and intensity of antibacterial drug use.Different scores were assigned to each indexi and scoring methods were developed.By dividing all drugs in the hospital medication catalog into three categories A,B,and C and assigning them different weights,as well as setting reasonable target values for each indexi,the hospital guided clinical departments to use drugs rationally.The proportion of drugs in hospital Z decreased from 28.75%in 2020 to 25.44%in 2022,the proportion of medical service revenue increased from 22.97%to 28.40%,the per capita outpatient drug cost decreased from 170 yuan to 166 yuan,and the per capita inpatient drug cost decreased from 7318 yuan to 5983 yuan.The number of departments with a 100%reasonable drug use rate increased from 11 in September 2021 to 16 in September 2022,and the intensity of antibacterial drug use decreased by 35.84%.The opplication of this drug performance appraisal system partly optimized the hospital′s income structure,controlled the growth of drug costs,promoted the rational use of drugs,so as to provid references for the rational drug use management of tertiary public hospitals.