医院基本药物网格化管理模式构建与效果评价

Construction and Effectiveness Evaluation of the Grid Management Model for Essential Drugs in a Hospital

目的 评价医院基本药物网格化管理模式的应用效果。方法 构建医院-药剂科-临床科室三级联动体系的网格化管理模式,对医院基本药物开展管理。通过医院信息系统提取2019年1月至2023年12月的基本药物数据,统计基本药物网格化管理模式构建前(2019年)和构建后(2020年至2023年)的门诊患者基本药物处方占比、住院患者基本药物使用率、基本药物医院配备使用金额及占比、基本药物采购品种数及占比、出院患者基本药物总费用及次均费用、门诊和急诊患者基本药物次均费用,评价干预效果。结果 2019年至2023年,门诊患者基本药物处方占比、住院患者基本药物使用率、基本药物医院配备使用金额及占比、基本药物采购品种数及占比、出院患者基本药物总费用及次均费用分别为31.64%,63.26%,67.10%,68.89%,69.25%;96.65%,98.82%,96.79%,96.81%,97.59%;1.24亿元、1.32亿元、1.47亿元、1.56亿元、1.62亿元;31.61%,35.75%,35.76%,35.07%,35.97%;364种、429种、456种、461种、453种;33.89%,36.20%,38.06%,38.24%,38.59%;6 742.13万元、7 137.08万元、8 341.59万元、8 418.86万元、8 330.65万元;790.00元、876.67元、927.08元、881.00元、772.46元。构建后,以上指标均提升,且门诊和急诊患者基本药物次均费用逐年增加(H=37.443,P=0.000)。结论 与常规基本药物管理模式相比,基本药物网格化管理模式能促进医院基本药物的规范化管理和使用,减少医保开支。

Objective To evaluate the application effect of the grid management mode for essential drugs in a hospital.MethodsA grid management model for the three-level linkage system of hospital-pharmacy-clinical department was constructed to manage the essential drugs in the hospital.The data of essential drugs from January 2019 to December 2023 were searched through the hospital information system(HIS) to calculate the proportion of essential drug prescriptions for outpatient patients,the utilization rate of essential drugs for inpatients,the hospital equipment amount and proportion of essential drugs,the procurement varieties and proportion of essential drugs,the total and average cost of essential drugs for discharged patients,and the average-time cost of essential drugs for outpatient and emergency patients before(2019) and after(2020 to 2023) the construction of the grid management model for essential drugs.Results From 2019 to 2023,the proportion of essential drug prescriptions for outpatient patients were 31.64%,63.26%,67.10%,68.89%,and 69.25%,respectively;the utilization rate of essential drugs for inpatients were96.65%,98.82%,96.79%,96.81%,and 97.59%,respectively;the hospital equipment amount of essential drugs were CNY 124 million,CNY 132 million,CNY 147 million,CNY 156 million,and CNY 162 million,respectively;the hospital equipment proportion of essential drugs were 31.61%,35.75%,35.76%,35.07%,and 35.97%,respectively;the procurement varieties of essential drugs were364 kinds,429 kinds,456 kinds,461 kinds,and 453 kinds,respectively;the procurement proportion of essential drugs were 33.89%,36.20%,38.06%,38.24%,and 38.59%,respectively;the total cost of essential drugs for discharged patients were CNY 67.421 3 million,CNY 71.370 8 million,CNY 83.415 9 million,CNY 84.188 6 million,and CNY 83.306 5 million,respectively;the average-time cost of essential drugs for discharged patients were CNY 790.00,CNY 876.67,CNY 927.08,CNY 881.00,and CNY 772.46,respectively.After the construction of the grid management mode for essential drugs,the above indexes all increased,and the average cost of essential drugs for outpatient and emergency patients significantly increased(H = 37.443,P = 0.000).Conclusion Compared with the conventional management mode of essential drugs,the grid management mode of essential drugs can promote the standardized management and use of essential drugs in hospitals,and reduce the medical insurance expenditure.