国内医院处方审核与点评开展情况及分析

Investigation and analysis of prescription review and evaluation in Chinese hospitals

目的:了解国内不同地区、不同级别医院的处方审核及点评工作开展情况,分析其影响因素,为进一步开展该项工作提供参考。方法:在全国范围内二级和三级医院中,通过电子调查问卷的形式,了解处方审核与点评工作开展情况。结果:样本医院中,处方前置审核、处方审核、处方点评的开展率分别为42.7%、84.6%、95.8%。特殊处方审核人资质高于一般处方,以多重用药处方最为明显。一般处方中,急诊处方、住院医嘱、门诊处方审核难度依次递减;静脉配置处方以及多重用药处方审核难度最大。处方审核及点评基本处于无偿状态。开展处方前审核仅8.6%的医院认为无压力,44.3%医院认为很有压力;压力主要原因在于缺乏电子审方系统及药师的规模和能力不足。结论:处方审核与点评是开展率较高的药学服务项目,但前置审方的开展严重不足;具有政策引导和政策支持的地区及医院处方点评的开展率相对较好;通过培训、计算机辅助系统、区域点评等多种手段可提高药师处方审核及点评的能力;卫生行政部门、医院可通过补偿、绩效等手段促进处方审核和点评工作的开展。

Objective: In different regions and hospitals, the work of prescription review and evaluation was investigated. Analyzed the influencing factors of prescription review and evaluation. Provided reference for the next step of prescription review and evaluation. Methods: Electronic questionnaires were distributed in Grade II and Grade III hospitals nationwide. Statistics on the rate of prescription review and evaluation. To evaluate the qualification, time and difficulty of different types of prescription reviewers. Investigate the compensation mechanism of prescription evaluation and the pressure of prescription pre-review. Results: The rate of prescription pre-review, prescription review and prescription evaluation was 42.7%, 84.6% and 95.8% respectively. The qualification of special prescription reviewers is higher than that of general prescriptions, especially for multi-drug prescriptions. The difficulty of review in general prescription is decreasing successively for emergency prescription, inpatient prescription and outpatient prescription. Iv and multidrug prescriptions are the most difficult. Prescription review and evaluation are basically free of charge. Only 8.6% of the hospitals considered that there was no pressure, and 44.3% considered that there was a lot of pressure. The main reason for the pressure is the lack of electronic prescription system and the scale and capacity of pharmacists. Conclusion: Prescription review and evaluation is a high development rate of pharmaceutical care, but the development rate of pre-review prescription is seriously insufficient. The development rate of prescription evaluations in regions and hospitals with policy guidance and support is relatively good. Through training, computer aided system, regional evaluation and other means to improve pharmacists prescription review and review ability. Health administration departments and hospitals can promote the development of prescription review and evaluation by means of compensation and performance.