DRG下医保精细化管理助力临床合理用药的实践探索

Practice and Exploration of Fine Management of Medical Insurance under DRG to Help Clinical Rational Drug Use

通过疾病诊断相关分组(Diagnosis Related Groups,DRG)下医院医保精细化管理的有益实践,进一步改善临床合理用药管理,规范临床诊疗行为。本文针对某省属医院医保管理中发现的临床用药问题,联合各职能部门,从医保精细化管理着手,利用信息系统进行智能控费,重点通过药品限制支付管理嵌入临床路径、抗菌药物院内三医联动管理、营养制剂合理用药-营养风险筛查嵌入医嘱端等方式,不断规范临床用药行为,为改善医院合理用药管理提供借鉴。

To further improve clinical rational drug use management under diagnosis related groups(DRG),standardize clinical diagnosis and treatment behavior,promote the high-quality development of health service,and maintain people′s health through the beneficial practice of fine management of hospital medicare management.Aiming at the clinical medication problems found in the hospital medicare management of a provincial hospital,jointing functional departments,starting from the fine management of medicare,the use of information system of intelligent control,mainly through drug limit pay management embedded clinical pathway,antibacterial drugs in the“Three medical linkage”management,supplements the rational use of drugs and the nutritional risk screening is embedded in the doctor′s order side,etc.,to continuously standardize clinical medication behavior.