汶川地震后1月内某院应急药品使用费用分析

Costs of emergency medicines in West China Hospital within one month after Wenchuan earthquake

目的:基于汶川地震伤病员疾病谱的药品实际使用情况,分析某院在汶川地震后1月内应急药品使用金额。方法:收集该院震后1月内,伤病员的住院情况,应急药品使用金额以及随天数的变化情况,使用Excel软件录入数据,统计分析地震后1月内伤病员具体药品的日均费用、人均费用、日均差额和人均差额。结果:汶川地震后1月内,该院收治伤病员共1 839人,ICD-10标化为伤情的人数占91.22%,病情占8.78%。震后1月内,住院人数与药品使用金额波动趋势一致,提示药品费用趋势合理。使用金额排名前五位的药物分别为抗微生物药物,调节水、电解质及酸碱平衡药物,生物制品,营养治疗药物,消化系统药物,符合地震伤病员疾病谱。在使用金额不低于5万元的药理分类中,排名靠前的多为进口和注射剂型药物;其中,进口药物人均费用和日均费用均值分别是国产的1.88倍和1.51倍,注射剂型药物人均费用和日均费用均值分别是非注射剂型的6.13倍和3.72倍。结论:影响应急药品使用金额的因素有:(1)地震伤病员的人数及病情;(2)药物的单价及用量;(3)药物的产地;(4)给药方式,注射、吸入或口服。灾后应急药品保障应以伤情为主,以注射剂型为主。应急救援时,选择使用方便、剂量合理、符合疾病谱的药物,以保证应急救援的及时有效。

OBJECTIVE To analyze costs of emergency medicines in West China Hospital within one month after Wenchuan earthquake based on actual medication of victims’ disease spectra.METHODS Emergency medicine data were collected as evaluation index in West China Hospital within one month after Wenchuan earthquake,including daily cost and other information of patients.Then,data were entered using Excel software to statistically analyze average cost per day/person,difference in average cost per day/person,and average cost per day/person when DUI=1,etc.RESULTS During one month after the earthqueke,1 839 victims were treated in the hospital.According to ICD-10,injuries occurred in 91.22% of total victims,and illness in 8.78%.During one month after the earthquake,costs changed consistently with number of victims,implying that change of costs was rational.According to classification of pharmacology,drugs with top5 costs were antibacterial drugs,water electrolyte and acid-base balance drugs,biological products,nutrient drug and digestive system drugs.Mean value of average cost per day/person of imported medicine was 1.88/1.51 times more than that of domestic medicine.Meanwhile,mean value of average cost per day/person for injection was 8.73/3.72 times more than those without injection.CONCLUSION Factors affecting medicine costs：number of patients and disease conditions;unit price and consumption of drugs;production place;administration route,injection,inhalation or oral administration.In order to ensure the timely,safe and effective medication,injection should be given priority to injured people after a disaster.Drugs should be also used based on reasonable dosage,convenience-to-use as well as need of the sick.