干预5个病种用药对制定可比药占比的影响

Research on the Influence of Intervention of Comparable Drug Cost Proportion in 5 Diseases

目的 将用药水平与制定科学合理的药占比指标联系起来,即通过干预用药,提高合理用药水平,以合理的用药水平客观反映(测算)出一个真实可行的药占比,为制定科学合理的药占比指标提供依据。方法 在调研的基础上,确定5个治疗方案较单纯、病例数相对较多且无其他合并症,或虽有其他合并症但不需要治疗且不影响疾病本身发展和转归的病种纳入本研究,对住院总费用、药品费用、药占比、处方(医嘱)用药不合理率等指标进行考核,共干预4轮,干预结束从横向和纵向对干预结果进行比较分析。结果 5个干预病种的药占比平均降低了11.19个百分点,5个病种的药品费用、药占比、处方(医嘱)用药不合理率呈逐年下降趋势,差异有统计学意义(P <0.05),从横向和纵向对结果进行比较均认为干预用药有效。结论 医院可借此制定科学合理的药占比,与干预病种对照,剔除各种影响因素,医院总体药占比至少可以降低到干预病种平均药占比降幅的一半,即在现行基础上再降低至少5.5个百分点,同时也可为县级公立医院相关政策的制定提供借鉴。

Objective To provide scientific basis for establishing a scientific and rational index of drug cost proportion. Drug use level is associated with a scientific and reasonable drug cost proportion,so that a rational drug use level which can objectively reflect a feasible drug cost proportion is improved through intervention of drugs. Methods On the basis of investigation, 5 disease categories which had more simple treatment protocols, more case numbers, and had no other complications, or other complications but no need to treat and dis not affect the development and prognosis of diseases themselves were enrolled in this study. The total hospitalization expenditures, drug expenses, drug cost proportion and unreasonable rate of prescription drug use were evaluated. Intervention results were compared and analyzed in vertical and horizontal aspects. Results Drug cost proportion of the 5 intervention disease categories was 11.19 percent lower than the average;drug cost, drug cost proportion and the irrational rates of prescription of the 5 diseases decreased year by year, and the differences were statistically significant (P < 0.05). The intervention of drug use was effective in vertical and horizontal aspects. Conclusion A scientific and rational drug cost proportion could be established based on this study,and general drug cost proportion could be reduced to half of decreasing range of intervention disease categories,which will reduce 5.5 percent on the current basis. Meanwhile,It can also provide reference for the establishment of relevant policies in county-level public hospitals.