我院辅助用药合理使用的管控实践

Practice of Management and Control of Rational Adjuvant Drug Use in Our Hospital

目的:为加强辅助用药的管控、促进医院合理用药提供参考。方法:介绍我院对辅助用药的管理措施,引入"辅助用药使用强度"至考核管理中,收集我院实施辅助用药管理前后的相关数据,以药占比、辅助用药使用强度、辅助用药使用金额等为指标进行比较以评价管理效果。结果:通过加强对辅助用药的管理,采取量化指标、考核到组、监测预警、超限停药、限量采购、医师培训等信息技术与行政干预等措施,我院辅助用药管理成效显著,2016年5月(开始实施管控)与2017年6月辅助用药金额分别为1 943.92、540.57万元,药占比分别为39.90%、33.76%;与管控前比较,管控后各科室辅助用药使用强度下降比例达12.86%～86.32%,不合理用药问题数从639例(在535份病历中)下降到147例(在538份病历中)。结论:我院采取的加强辅助用药管控的措施,不仅减少了辅助用药的费用、降低了药占比,还促进了临床合理用药。

OBJECTIVE:To provide reference for strengthening the management and control of adjuvant drug,and improving the rational drug use.METHODS:The management measures of adjuvant drug in our hospital were introduced.A concept of“adjuvant drug use density”was introduced to assessment management,and then relevant data of our hospital was collected before and after the implementation of adjuvant drug management.The effects of management were evaluated using drug proportion,adjuvant drug use density and cost of adjuvant drug as indexes.RESULTS:The significant achievement in our hospital was obtained through technological and administrative intervention as strengthening adjuvant drug management,the quantitative index,group assessment,monitoring and early warning,drug withdrawal due to out of limit,limited purchasing,physician training.The cost of adjuvant drug were 1 943.92 ten thousand yuan in May 2016(the beginning of management and control)and 540.57 ten thousand yuan in Jun.2017.The drug ratios were 39.90%and 33.76%.Compared with before management,the decline proportion of adjuvant drug use density reached 12.86%-86.32%after management.The number of irrational drug use case decreased from 639 cases(among 535 medical cases)to 147 cases(among 538 medical cases).CONCLUSIONS:The adjuvant drug management and control of our hospital can not only reduce adjuvant drug expense and drug occupation ratio,but also enhance the rational drug use.Nevertheless,there are some difficulties yet on account of lacking of occupation policies and criteria.