2015年某市三甲医院社区获得性肺炎的用药合理性及费用分析

Drug usage and costs of community-acquired pneumonia in a Grade Ⅲ-A hospital in 2015

目的调查2015年某市三甲医院社区获得性肺炎住院患者的费用、用药情况,为开展循证药学研究提供基线数据。方法提取医院信息管理系统2015年出院病历中第一诊断为社区获得性肺炎的费用、用药等数据并进行统计分析。结果社区获得性肺炎住院患者在性别、民族、年龄方面数据与文献报道结果基本一致。住院费构成比方面,药费所占比例最大,与发达国家存在明显不同;治疗存在抗感染药物选药起点高,选药不适宜、联合用药频率高的问题。平喘化痰药物、糖皮质激素、抗过敏药物等对症治疗用药存在用药指征过宽及过度使用问题。结论应关注社区获得性肺炎的抗菌药物使用的合理性,本地区细菌耐药性和对症治疗辅助用药的成本-效果,比较有效性、安全性、适用性、经济学证据,以支持其临床使用。

Objective To investigate the costs and medication in hospitalized patients with community-acquired pneumonia in a Grade Ⅲ-A hospital in 2015 and provide baseline data for further evidence-based study.Methods The data of medication and costs of patients with community-acquired pneumonia as the first diagnosis in 2015 was extracted,and the statistical analysis was carried out.Results The data of gender,nationality and age of hospitalized patients with community-acquired pneumonia were basically the same as those reported in the literatures.The proportion of drug cost in hospitalization expenses was the largest,which was obviously different from that in developed countries.In the course of treatment,the starting point of the anti-infective drug was high,the medicine selection was not suitable and the combination drug use was more.Symptomatic drugs for relieving asthma and resolving phlegm,glucocorticoids and anti-allergic drugs had the problems of excessive drug use.Conclusion We should pay attention to the rational use of the antibacterial drugs in patients with community-acquired pneumonia,bacterial drug resistance and cost-effectiveness of adjuvant drugs,and the comparicon of validity,safety,applicability,and economic evidence to support its clinical use.