天水市中西医结合医院实施重点监控前后辅助用药临床应用情况调查

Investigation into Clinical Use of Adjuvant Drugs Before and After Implementing Key Monitoring in Tianshui Combine Traditional Chinese and Western Medicine Hospital

目的:对天水市中西医结合医院辅助用药在实施重点监控前后的临床应用情况进行调查分析。方法:对照甘肃省《辅助用药重点监控品种目录》,对我院辅助用药进行归类;统计2016和2017年2~5月份同期药占比、辅助用药比和辅助用药占药品费用的比例;对神经外科等五个重点科室11个病区的辅助药品使用情况进行统计,比较实施重点监控前后的变化情况。结果:实施重点监控前辅助用药月销售额高达119.36万元,药占比为33.85%、辅助用药占总费用的7.36%,占药品收入的21.75%;实施重点监控后辅助用药月销售额仅为13.85万元,药占比为32.70%、辅助用药占总费用的0.73%,占药品收入的2.24%,这就说明辅助用药滥用情况比较严重。结论:只有理顺药品定价体系,加强流通环节的监管,细化药品适应症(功能主治)范围,规范临床医疗行为,才能充分发挥辅助用药的疗效。[关键词]医院;辅助用药;重点监控;药品应用;

Objective: To survey and analyzed clinical use of adjuvant drugs before and after implementing key monitoring in Tianshui Combine Traditional Chinese and Western Medicine Hospital. Methods: By comparing catalogue of Key Monitoring Varieties of Adjuvant Drugs of Gansu province, adjuvant drugs of our hospital were classified, hameochronous proportion of the herbs, the ratio of adjuvant drugs and the ratio of adjuvant drugs cost in drug cost were counted from February to May of 2016 and 2017. The use of adjuvant drugs in 11 wards of five departments including neurosurgery department were counted, the change before and after implementing key monitoring were compared. Results: Monthly sales of adjuvant drugs reached 1 193 600 Yuan before implementing key monitoring, the proportion of drugs was 33.85%, the cost of adjuvant drugs held 7.36% of total cost, and 21.75%of medicinal incomes; monthly sales of adjuvant drugs reached 13 8500 Yuan after implementing key monitoring,the proportion of drugs was 32.70%, the cost of adjuvant drugs held 0.73% of total cost, and 2.24% of medicinal in comes; which demonstrated that the abuse of adjuvant drugs was severe. Conclusion: In order to fully exert clinical effects of adjuvant drugs, the pricing system of the drugs should be sorted out, the intermediate links monitoring should be enhanced, the range of medicinal indications should be refined and clinical medical behavior should be regulated.Keywords hospital; adjuvant drug; key monitoring; drug uses; investigation