基于药品监测大数据的内蒙古自治区儿童药品使用情况分析

Analysis of children’s drug use in Inner Mongolia based on big data of drug monitoring

目的分析内蒙古自治区公立医疗机构儿童药品使用情况,为全区儿童药品的合理应用以及儿童药品目录的完善提供参考。方法收集2023年内蒙古自治区全区各级公立医疗机构使用的儿童药品的通用名、规格以及剂型等信息,采用限定日剂量(DDD)和排序比(B/A)分析法挖掘全区儿童药品的用药频度、日均费用以及药物经济性,并且统计全区公立医疗机构儿童药品剂型、药物类别和用药衔接度。结果2023年内蒙古自治区全区1751家公立医疗机构配备的儿童药品品规数共计267个,包含12个药物类别,剂型以颗粒剂、口服溶液剂和糖浆剂为主,各级公立医疗机构使用频率较高的药品主要为解热、镇痛及抗炎药(多为中成药)和呼吸系统用药。三级、二级以及基层公立医疗机构儿童药品中用药频度最高的药品日均费用均较低,且大多数使用频率较高的药品的B/A值均在1附近;但是部分药品的B/A值较高,可能存在过度使用的现象。基层公立医疗机构与二级、三级公立医疗机构的药品衔接度均不足50%。结论内蒙古自治区全区儿童药品涉及的药物类别较为全面,且社会效益和经济效益的同步性良好,但是剂型较为单一且儿童专用品规和剂型较少。基层和二级公立医疗机构中成药的比例较高,用药风险不容忽视;基层医疗机构儿童药品与上级医疗机构衔接性略差。

OBJECTIVE To analyze the use of children’s drugs in public medical institutions in the Inner Mongolia Autonomous Region,and provide some reference for the rational use of children’s drugs and the improvement of children’s drug list in the whole region.METHODS The generic names,specifications,and dosage forms of children’s drugs were collected from all levels of public medical institutions in the Inner Mongolia Autonomous Region in 2023.The method of defined daily dose(DDD)and ranking ratio(B/A)were used to explore the frequency of drug use,daily average cost and cost-effectiveness of children’s drugs in this region,and the dosage forms,category,and drug use convergence of children’s drugs in medical institutions in the whole region.RESULTS In 2023,1751 public medical and health institutions in Inner Mongolia Autonomous Region were equipped with 267 kinds of children’s drugs,including 12 drug categories.The main dosage forms were granules,oral solutions,and syrups.The drugs that were frequently used in medical institutions at all levels were mainly antipyretic,analgesic,anti-inflammatory drugs(mostly Chinese patent medicines),and respiratory drugs.The daily average cost of children’s drugs with the highest DDDs in tertiary,secondary,and primary public medical institutions was low,and the B/A value of most drugs with higher DDDs was around 1.However,the B/A value of some drugs was high,which may lead to overuse.The drug use convergence between primary public medical institutions and secondary/tertiary public medical institutions was less than 50%.CONCLUSIONS The types of drugs involved in children’s drugs in Inner Mongolia Autonomous Region are comprehensive and the social and economic benefits are in good synchronization,but the dosage form is single and there are few special rules and dosage forms for children.The proportions of Chinese patent medicines in primary and secondary public medical institutions are high,and the risk of drug use should be paid attention.The cohesion between children’s drugs in primary public medical institutions and higher public medical institutions is slightly poor.