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我院重点监控药品管理实践和干预措施探讨
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| 篇名： | 我院重点监控药品管理实践和干预措施探讨 |
| TITLE： | |
| 摘要： | 目的：加强我院重点监控药品的管理，控制药品费用的增长。方法：完善原辅助用药目录，制定《临床科室重点监控药品管理规定》等规章制度，建立《重点监控药品目录》，同时结合建立重点监控药品动态/预警监控机制、实施重点监控药品比例责任制、开展处方和医嘱专项点评、完善奖惩措施等药事管理干预措施，建立全方位、多角度的管控体系，对重点监控药品进行管理。对我院临床科室2017年1－6月（干预前）与2017年7－12月（干预后）相关重点监控药品的使用情况进行分析。结果：干预后，我院重点监控药品使用金额与干预前比较整体降幅达39.96％，其使用金额在全院药品中所占比例降幅达36.02％（由干预前的23.68％降至15.15％）；全院人均重点监控药品费用下降48.41％，药占比由干预前的42.93％下降至32.23％；使用金额排名前20位的重点监控药品中有16种使用金额较干预前不同程度地下降；22个临床科室中重点监控药品比例超过标准监控线的科室由干预前的20个减至8个，大部分临床科室的重点监控药品比例均明显下降。通过专项点评，处方和医嘱抽查数量大幅增加，相应的不合理用药情况也更多地被发现。结论：我院采取重点监控药品管理措施后，药品费用得到大幅降低，重点监控药品的使用金额、比例均明显下降，能更有效地发现不合理用药问题，并减轻患者就医负担。 |
| ABSTRACT： | OBJECTIVE： To strengthen the management of key monitoring drugs in our hospital， and to control the increase of drug cost. METHODS： The former auxiliary directory was improved， and the key monitoring drugs were managed by formulating regulations and systems as Provisions for Key Monitoring Drug Management in Clinical Departments， constructing Key Monitoring Drugs List， adopting pharmaceutical administration intervention measures， such as establishing key monitoring drug dynamics/early warning monitoring mechanism， implementing responsibility system of key monitoring drug proportion， developing special comment on prescription and medical order， improving policy of awards and penalties， establishing omni-directional and multi-angle control system. The application of key monitoring drugs was analyzed in clinical departments of our hospital during Jan.-Jun. 2017 （before intervention） and Jul.-Dec. 2017 （after intervention）. RESULTS： After intervention， consumption sum of key monitoring drugs decreased by 39.96％， compared with before intervention； the proportion of key monitoring drugs in all drugs decreased by 36.02％ （decreasing from 23.68％ before intervention to 15.15％）. The per capita cost of key monitoring drugs decreased by 48.41％， and drug ratio decreased from 42.93％ to 32.23％. Among top 20 key monitoring drugs in the list of consumption sum， consumption sum of 16 kinds were decreased to different extents. Among 22 departments， the number of clinical departments with the proportion of key monitoring drugs over standard monitoring lines decreased from 20 before intervention to 8. The proportion of key monitoring drugs decreased significantly in most clinical departments. Through special comments， the number of prescriptions and medical orders checking had increased significantly， and the corresponding unreasonable drug use had been found more. CONCLUSIONS： After adopting key monitoring drug management measures in our hospital， drug cost have been greatly reduced， and consumption sum and proportion of key monitoring drugs have been decreased significantly so as to more effectively find out irrationality of drug use and relieve patients’ medical treatment burden. |
| 期刊： | 2018年第29卷第22期 |
| 作者： | 黎赛，盛小燕，梁椅文，张鑫，彭康 |
| AUTHORS： | LI Sai，SHENG Xiaoyan，LIANG Yiwen，ZHANG Xin，PENG Kang |
| 关键字： | 重点监控药品；药事管理；药占比；辅助用药；合理用药 |
| KEYWORDS： | Key monitoring drugs； Pharmaceutical administration； Drug ratio； Adjuvant drug；Rational drug use |
| 阅读数： | 738 次 |
| 本月下载数： | 21 次 |
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