16所医院单病种合理用药评价指标构建及应用

Construction and application of the rational drug use of single-disease index in 16 hospitals

目的通过建立单病种住院患者合理用药评价指标体系,比较不同群体用药差异,进而评估合理用药干预政策的实施效果。方法运用德尔菲法及其量化方法构建住院患者单病种合理用药指标体系。从16家医院采集冠状动脉粥样硬化性心脏病(以下简称为冠心病)住院患者药物消耗数据,应用宽泛入排标准,并按照不同年度和患者身份分为4个小组,应用建立的合理用药评价指标体系对4个小组患者用药情况进行对比研究。结果建立合理用药指标体系:包括"合理性"、"公平性"和"有效性"3个一级指标和"药物总费用"、"主要治疗药物费用占比"等8个二级指标。5755例患者数据纳入研究,研究表明合理医疗用药目录修订前后,在"药物总费用"、"住院天数"等指标存在显著性差异,目录适用人群与非适用人群,在"住院天数"、"主要治疗药物费用"等指标的差异缩小。结论研究建立的指标体系能够评价合理医疗干预政策对单病种合理用药水平的影响。

Objective The research group tried to set up the rational drug use inpatients index system to compare the differences between different crowds so as to evaluate the influence for Medical intervention policy to the level of the rational drug use.Methods This study founds a rational drug use of single-disease index system by delphi method.Select drug treatment data which from Coronary heart disease in 16 hospitals.Divide the above data into 4 groups according to certain rules providing a comparative study of the level of the drug with this index system.Results There are three first-class indicators（rationality,fairness,efficacy）and eight second-class indicators（total drug cost,main treatment cost ratio,and so on）in the evaluation index system.Data from 5755 patients showed that there are significant differences in total drug cost and hospital day after revision of Drug Catalogue for Reasonable Military Medical Treatment.The difference in hospital days and main treatment cost is also decreased between its applicable and non-applicable people.Conclusion The index system can evaluate the influence for medical intervention policy to the level of the rational drug use of single disease.