临床药师参与的处方点评与医保控费及DRGs干预前后我院住院患者质子泵抑制剂应用情况分析

Intervention effect analysis of the application of proton pump inhibitors in hospitalized patients in our hospital before and after carrying out prescription comments, medical insurance control costs and DRGs by clinical pharmacists

目的:探讨临床药师参与的处方点评与医保控费及DRGs对我院质子泵抑制剂干预效果。方法:对医院干预前(2017年4月至2017年6月)、干预第一阶段(2017年7月至2017年9月)、干预第二阶段(2017年10月至2017年12月)、干预第三阶段(2018年1月至2018年3月)质子泵抑制剂的人均消费金额和用药合理性进行对比和分析。结果:我院外科住院患者人均PPIs费用干预第一阶段平均增长率为-49.86%,干预第二阶段平均增长率为-42.33%,干预第三阶段平均增长率为-69.59%;内科住院患者人均PPIs费用干预第一阶段平均增长率为-12.29%,干预第二阶段平均增长率为-23.28%,干预第三阶段平均增长率为-35.74%。不合理使用率由干预前的47.5%降至第一阶段干预后的21.5%,并进一步降至第二阶段干预后的13.0%,至第三阶段干预后的4.5%。结论:临床药师参与的处方点评与医保控费及DRGs促进了我院质子泵抑制剂的合理使用,降低了我院质子泵抑制剂的使用费用,为患者减轻了经济负担。

OBJECTIVE To investigate the effect of prescription comments,medical insurance control costs and DRGs participated by clinical pharmacists on the intervention of proton pump inhibitors in our hospital.METHODS The per capita consumption of proton pump inhibitors was analyzed before the intervention(April 2017 to June 2017),in the first phase(July 2017 to September 2017),the second phase(October 2017 to December 2017),and the third phase of intervention(January 2018 to March 2018).RESULTS The average growth rate of the per capita PPIs cost of our hospital surgical inpatients was-49.86%in the first stage,-42.33%in the second phase,-69.59%in the third phase;the per capita PPIs of the internal medicine inpatients was-12.29%in the first phase of intervention,-23.28%in the second phase of intervention,and-35.74%in the third phase of intervention.The irrational application rate of PPI among inpatients in our hospital had been decreased from 47.5%before intervention to 21.5%in the first stage of intervention,and further decreased to 13.0%in the second stage of intervention,to 4.5%in the third stage of intervention.CONCLUSION The prescription comments,medical insurance control costs and DRGs participated by clinical pharmacists promote the rational use of proton pump inhibitors in our hospital,reduce the costs of proton pump inhibitors in our hospital,and reduce the economic burden for patients.