临床药师参与社区高血压患者家庭病床服务的成本-效果分析

Cost-Effectiveness Analysis of Family-Bed Service Participated by Clinical Pharmacists for Hypertension Patients in Community

目的探讨临床药师参与的家庭病床服务用于社区高血压患者的成本-效果。方法共纳入医院下属社区高血压患者120例,按是否接受临床药师参与的家庭病床服务分为干预组和对照组,各60例。随访24个月,对比家庭病床服务干预前后两组患者血压控制情况、用药品种数、用药费用及因不良心血管事件入院次数,并以因不良心血管事件入院次数为效果指标进行成本-效果分析。结果临床药师参与的家庭病床服务能明显提高血压达标率,明显降低舒张压;还可明显减少患者的用药品种数、费用和因不良心血管事件的入院次数,增量成本效果比远低于该院因心血管事件入院单次平均费用及2018年全国三级医院人均住院费用。结论临床药师参与家庭病床服务,可有效降低社区高血压患者的用药费用,减少因不良心血管事件入院带来的经济损失。

Objective To investigate the cost-effectiveness of family-bed service participated by clinical pharmacists for hypertension patients in community.Methods A total of 120 patients with hypertension in the community affiliated to our hospital were included and divided into the intervention group and the control group according to whether they accepted family-bed service participated by clinical pharmacists,60 cases in each group.After 24 months of follow-up,the blood pressure control,the number of drugs,the cost of drugs and the number of admission due to adverse cardiovascular events were compared between the two groups before and after the intervention,and the cost-effectiveness analysis was conducted with the times of admission due to adverse cardiovascular events as the effective index.Results Clinical pharmacists’participation in family-bed service could significantly improve the blood pressure compliance rate,and significantly reduce the diastolic blood pressure and the number of drug varieties,costs and the number of admission due to adverse cardiovascular events,and the incremental cost-effectiveness ratio was far lower than the average cost of a single admission due to cardiovascular events in our hospital and the per capita hospitalization expenses of national tertiary hospitals in 2018.Conclusion Clinical pharmacists’participation in family-bed service can effectively reduce the medication cost of hypertension patients in the community,and reduce the economic loss caused by admission due to adverse cardiovascular events.