医院重点监控药品应用分析及干预措施

The Application Analysis and Intervention Measures of Key Monitored Drugs in Hospitals

目的探讨重点监控药品有效管理的措施,以控制药品费用的增长。方法2018年12月制订河源市人民医院重点监控目录及管理制度,应用医院信息系统(HIS)调取2018年(干预前)与2019年(干预后)重点监控药品使用数据,分析医院重点监控药品使用情况、药占比及人均药品费用、使用金额排名前20位的重点监控药品使用变化情况及专项点评情况,评价重点监控药品的管理实践与效果。结果医院实施重点药品监控管理制度后,药占比下降幅度为0.96%,重点监控药品使用金额与干预前比较整体降幅达22.95%,前20位药品总使用金额较干预前降幅达21.56%;通过专项点评,无适应证用药和用法用量不适宜有下降的趋势。结论医院重点监控药品品种的监管措施取得了一定成效,药占比虽下降不明显,重点监控药品使用金额有大幅度下降,在一定程度上促进了临床合理用药。但重点监控药品品种的目录和重点监控处方点评的方法有待进一步完善。

Objective To explore the effective management measures of key monitored drugs in order to control the growth of drug costs.Methods The contents and management institution of key monitored drugs was set in December 2018 in Heyuan People’s Hospital.We used the hospital information system(HIS)to collect data on the use of key monitored drugs in 2018(before the intervention)and 2019(after the intervention),analyzing usage of the key monitored drugs,percentage of drug expenditure,the per capita drug cost,the top 20 key monitored drugs and the special prescription comment,to evaluate the management practice and effect on key monitored drugs.Results After the implementation of the management system of key monitored drugs,the drop in percentage of drug expenditure was 0.96%,the drop in total amount of key monitored drugs was 22.95%compared with that before the intervention,and the drop in total amount of the top 20 key monitored drugs was 21.56%.Through special reviews,there was a trend of decrease in the unindicated drug use and inappropriate dosage.Conclusion The supervision measures of the key monitoring drugs in our hospital have achieved certain effects,although the proportion of drugs decreased unconspicuous.The total amount of key monitored drugs decreased by a large margin,which promoted the drugs rational use in clinics in some degree.However,the contents and the method of commenting on prescription of the key monitored drugs needs to be further improved.