我院门诊收费前审核处方的运行实践

Operation Practice of Outpatient Prescriptions Audit before Payment in Our Hospital

目的:为医院药房实行药师收费前审核处方提供参考。方法:对我院实现收费前处方审核干预的相关管理措施进行介绍,并通过分析比较管理前后各1年抽取的各1 200张门诊处方的处方合格率及不合理处方情况,对收费前审核处方的管理效果进行评价。结果:我院通过应用信息化审核系统、制订处方审核标准、培养审核药师队伍、建立审核岗位制度、建立处方点评及问题处方反馈机制、建立沟通机制等措施实现了药师在收费前对处方进行审核和干预管理。管理后1年共审核处方189 665张,未通过审核的处方14 581张,占7.69%;干预后医师未修改处方606张,有效干预率为95.84%。与管理前比较,管理后处方合格率由88.83%上升到98.67%(P<0.01),处方不合理情况中超剂量用药、不符合医保适应证、处方超量等情况减少为0。结论:医院药房实行药师在收费前对处方进行审核、干预,不仅切实可行,且可提高医院处方质量、促进临床合理用药。

OBJECTIVE：To provide reference for prescriptions audit before payment in hospital pharmacy. METHODS：The management measures of prescriptions audit and intervention before payment in our hospital were introduced. 1 200 outpatient prescriptions within 1 year before and after management were subjected to a statistical analysis. The effects of prescriptions audit before payment were evaluated through analyzing and comparing qualification rate of prescription and unqualified prescriptions. RESULTS：Our hospital adopted a series of measure to realize prescriptions audit and intervention before payment by clinical pharmacists,such as using information audit system,formulating audit standard,educating pharmacists,establishing audit job system,prescriptions review and feedback system,setting up communication system,etc. Of the total audited 189 665 prescriptions,14 581（7.69%）failed to audit and 606 prescriptions hadn＇t been revised after 1 year management,with effective intervention rate of 95.84%. Compared with before management,the prescription qualification rate increased from 88.83% to 98.67% after management（P〈0.01）. The quantity of overdose,inconformity with medical insurance,overload and other conditions reduced to 0. CONCLUSIONS：It is feasible for pharmacists to audit and intervent prescriptions before payment in hospital pharmacy to improve prescription qualification and promote rational drug use in the clinic.