药品零差价实施前后我院门诊处方药品情况分析

Analysis of outpatient prescription drugs before and after the implementation of the policy of drug's zero profit

目的分析我院实施药品零差价政策前后门诊用药情况。方法从我院门诊中分层随机抽取共8400张处方,比较药品零差价政策实施前后门诊处方金额、基本药物、抗菌药物和注射剂使用的变化情况;并对其中诊断为高血压、糖尿病、急性上呼吸道感染、急性肠炎、儿童支气管肺炎5种常见病的1890张处方费用的变化情况进行分析。结果药品零差价政策实施后,呼吸内科、骨科脊柱外科、普通外科结直肠肛门病门诊、妇科和产科门诊处方金额平均值均较实施前显著降低(P<0.05);糖尿病的门诊处方金额平均值由政策实施前的434.69元下降到政策实施后的383.55元(P<0.05);呼吸内科、肾内科、血液内科、风湿免疫科和儿科在政策实施后基药金额占比较实施前升高(P<0.05);产科门诊处方注射剂使用比例由11.17%下降到5.50%,儿科门诊处方注射剂使用比例由22.17%下降到17.75%(P<0.05)。结论药品零差价政策实施后,部分科室门诊处方金额有所降低,部分科室基本药物占处方用药比例较实施前有降低趋势,所有科室抗菌药物及多数科室注射剂的使用情况较实施前无显著变化。

Objective To analyze outpatient prescription drugs before and after the implementation of the policy of drug's zero profit.Methods A total of 8400 prescriptions were randomly selected from the department of outpatient in our hospital.The changes in the amount of outpatient prescriptions,and application of essential medicine,antibiotics and injections in outpatient prescriptions before and after the implementation of the policy were compared.A total of 1890 prescriptions of five common diseases,which were diagnosed as"hypertension","diabetes","acute upper respiratory infection","acute enteritis"and"bronchopneumonia",were selected in outpatient department.The change of the prescription costs of these common diseases was analyzed.Results After the implementation of the zero-profit policy,the average amount of prescriptions for respiratory,orthopedic spine surgery,general surgery colorectal anal disease clinic,gynecology and obstetrics clinics was significantly lower than before the implementation(P<0.05).The average amount of outpatient prescription for diabetes clinics decreased from 434.69 yuan before the implementation of the policy to 383.55 yuan after the implementation of the policy(P<0.05).The amount of base medicine in the Department of respiratory,nephrology,hematology,rheumatology and pediatrics increased after the implementation of the policy(P<0.05).The proportion of prescription injections in obstetric clinics decreased from 11.17%to 5.50%,and the proportion of prescription injections in pediatric outpatient clinics decreased from 22.17%to 17.75%(P<0.05).Conclusion After the implementation of the zero-profit policy for drugs,the prescription amount of outpatient clinics in some departments has decreased.The proportion of essential drugs in some departments has decreased compared with the previous prescriptions.The use of antibacterial drugs and injections has not changed significantly.