抗感染药品应用的经济学分析

The Economic Analysis on the Anti-infective drug Application

目的从不同角度对不同科室、不同感染部位等感染患者用药及感染药品的费用情况进行分析,找出医院感控重点,力求通过该研究节约卫生资源,用于迫切需要卫生资源的地方,以创造更大的社会效益和经济效益。方法以回顾性调查方法对2010年1月~12月某大型三级甲等医院内、外科临床部发生感染患者的相关信息进行收集整理后进行费用测算对比。结果内、外临床部感染患者所使用的抗感染药品占药品总额比例相差不大;注射用头孢哌酮钠舒巴坦钠、注射用美罗培南、注射用亚胺培南西司他丁钠占据抗感染药物用药频率的前三位;内科临床部感染药品总费用及人均感染药品费用排名均在前五位的科室有呼吸科、血液病科、肾病科;外科临床部药品总费用及人均感染药品费用排名均在前五位的科室有外科重症监护医学科和肝胆外科;不同感染部位的感染用药情况中,感染药品总费用最高的部位是下呼吸道;人均感染药品费用排在第一位的部位是腹水。结论医院感染控制的重点部位应在上、下呼吸道、胃肠道、泌尿道等。通过加强医院感染管理,规范医务人员的行为,合理使用抗菌药物,降低发病率,不仅可减少患者痛苦和经济负担,减少医疗纠纷,还可加快病床的周转、同时降低医院感染所带来的经济损失。

Objective To analyse the anti-infective drug usage and the cost of the anti-infective drugs from different angles and different departments and different portion,to find out the key point of hospital infection control and to save health resources, to create more social benefits and economic benefits. Methods To calculate and contrast the information and cost of the infected patients in a 3 Grade A hospitals' internal medicine department and surgery department between January and December on 2011. Results The proportion of anti-infective drugs for total drug cost in the internal medicine department and surgery department are very close; The first three DDDs of the anti-infective drug are as follows: Shu ba jotham sodium cefoperazone sodium for injection、Meropenem for injection and Imipenem and Cilastatin Sodium for injection; The top five departments of the total costs and average costs in the internal medicine department is pneumology department、hematology department、nephropathy department; and in the surgery department is ICU、hepatic surgery; The portion of the highest total anti-infection drugs cost is the lower respiratory tract; and the highest average anti-infection drugs cost is ascites. Conclusion Key parts of hospital infection control should be in the upper and lower respiratory tract and gastrointestinal tract and urinary tract, etc. By strengthening the hospital infection management, to standardize the behavior of the medical staff and to provide references for rational usage of drugs, cut down the medical dispute,at the same time reduce the economic loss brought by the hospital infection.