药占指数的概念及其应用研究

Study on the Conception of Drug Cost Index and Its Application

摘要目的：提出药占指数（DCI）的概念，并将其应用于临床药费控制管理。方法：通过对医院内部n个临床科室药品费用（Di）和医疗费用（MDi）的数学分析，引入药占指数的概念，推导出计算临床科室（i）的药占指数（DCIi）计算公式，并考察药占指数作为指标替代药占比分析全院药品使用情况。结果与结论：药占指数表示临床科室对全院药占比的贡献，数值越高贡献越大，取值范围在-0.5-0.5，计算公式：DCIi=（Di-0.5MDi）/n∑i=1MDi.当Di〈0.5MDi时，-0.5〈DCIi〈0；当Di〉0.5MDi时，0〈DCIi〈0.5；当Di=0．5MDi时，DCIi为0。考察结果证明，药占指数比药占比更能够公平地反映各临床科室的用药费用比例变化，方便医疗管理人员利用该指数对全院用药情况实行指标管理。

OBJECTIVE： To introduce a noval conception of drug cost index （DCI） and to use it in clinical drug cost control. METHODS： Through mathematic analysis of drug cost （Di） and medical cost （MDi） of n clinic departments in a hospital, an equa- tion to calculate DCL of clinic department （i） was derived by introducing the conception of DCI. The use of drugs in the hospital was analyzed using DCI instead of drug cost ratio （DCR） as index. RESULTS ＆ CONCLUSIONS： The value of DCL ranging from --0.5 to 0.5 is the numeric contribution of clinical department （i） to DCR of whole hospital, with the more of the value, the n higher contribution is. The equation is DCL=（Di-0.5MDi）/n∑i=1 MDi. If Di〈0.5MDi, the value of DCL is less than 0 but more i=1 than --0.5; if Di〉0.5MD,, the value of DCL is more than 0 but less than 0.5; if Di=0.5MDi, the value of DCI, is zero. The result of calculation shows that DCI can impartially reflect the variance of drug cost scale in clinical departments and provide some meth- od for hospital management personnel to conduct drug use management of whole hospital.