北京市医疗保险住院患者灯盏细辛、灯盏花素注射剂用药情况调查与分析

Investigation and analysis of the usage of Deng Zhan xi xin and Deng Zhan hua su Injections in inpatients covered by Beijing medical innsurence system

目的为了了解医疗保险住院患者灯盏细辛、灯盏花素注射剂用药情况,进一步加强医疗保险费用管理,为制订北京市医疗保险政策提供科学依据,我们对2004年北京市5家医院医保患者灯盏细辛、灯盏花素注射剂使用情况进行了回顾性调查研究。方法抽取2004年北京市5家医保定点医院的738份使用灯盏细辛、灯盏花素注射剂的医保住院患者病历,填写北京市医疗保险住院患者“灯盏”注射剂用药情况调查原始数据表,对采集的数据进行病人基本信息、用药情况等方面的统计分析。结果被调查医保住院患者灯盏细辛注射剂平均剂量(172.4±19.1)mg,最大剂量225mg,最小剂量45mg;注射用灯盏花素平均剂量(45.2±12.0)mg,最大剂量100mg,最小剂量10mg;平均疗程(12.8±5.4)d,最长疗程55d,最短疗程1d;给药次数均为每日1次;给药途径均为静脉滴注;用药适应证总体与说明书适应证相符比例占28.3%,与2005年医保目录限制适应证相符率为57.6%;“灯盏”注射剂适应证人均合并使用药物5.6种;不良事件发生率为0.95%。结论北京地区医保住院患者使用“灯盏”注射剂存在不合理用药情况,北京市医疗保险管理等相关部门应采取措施,加强管理,规范用药行为。

Objective To review Dengzhan Xixin and Dengzhanhua Su Injection medication use in hospitalized cases of Medical Insurence in Beijing, and make reference for expense management and policy formulation of Medical Insurence. Methods 738 inpatients cases in 5 designated hospitals of Medical Insurence in 2004 were sellected and the primitive data investigation form were filled. Frequency distributions and descriptive statistics were calculated and data were statistical analyzed. Results For 738 inpatient cases of Medical Insurance in designated hospitals, average dose of Dengzhan Xixin and Dengzhanhua Su Injection were （172.4±19.1） mg and （45.2±12.0） mg, average course of treatment was （12.8±5.4） d, administration frequency was 1 time/d, route of administration was inter＇venous drop infusion, the ratio matching the indication of description was 28.3%, the ratio matching the indication of Medical Insurence catalogue was 57.6 %, the mean number of complicating medication was 5.6, the incidence of adverse event was 0.95%. Conclusion There was inappropriate medication use in these cases, the departments of Medical Insurence should adopt measures to strengthen the management and regulate the behavior of medication.