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中心药房一体化管理模式的构建与评价
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| 篇名： | 中心药房一体化管理模式的构建与评价 |
| TITLE： | Establishment and evaluation of an integrated central pharmacy management model |
| 摘要： | 目的 构建住院药房与静脉用药调配中心（PIVAS）一体化的中心药房管理模式，评价其在运营成本构成、调剂产出与调剂效能等方面的成效及经济学价值。方法通过空间整合、岗位柔性排班、智能设备应用及双重处方审核体系，将住院药房与PIVAS整合，实施一体化管理。选取苏州大学附属第四医院（以下简称“我院”）2023年运营数据进行分析，以全国中位数据及同地区仍实行住院药房与PIVAS二元管理模式的外院数据为对照，采用作业成本法计算运营成本，比较三者在调剂产出、调剂效能及单位作业成本方面的差异；并采用成本-效益分析法，计算净效益（NB）与增量成本效果比（ICER）以进行经济性评价。结果一体化管理模式下，我院中心药房总运营成本为396.83万元，较外院药房（449.90万元）降低11.80%，其中耗材成本下降38.73%，人力成本下降10.99%；医嘱调剂总量（361.34万条）较外院（251.67万条）高出43.58%；人均日调剂医嘱量达471.41条，为外院药房（135.20条）的3.5倍；单位作业成本为1.10元，较外院药房（1.79元）降低38.55%；NB为75.52万元，ICER为－2.36。PIVAS业务层面，我院普通输液（含抗菌药物）人均日调剂量为50.83组，高于全国PIVAS中位数（49.11组）和外院药房（36.14组）；危害药品人均日调剂量为0.86组，高于全国中位数（0.70组）和外院药房（0.16组）。结论我院构建的中心药房一体化管理模式在业务量增长的情况下，实现了运营成本下降与人员效能提升；该模式兼具住院药房与PIVAS双重功能，在调剂产出、调剂效能、单位作业成本控制及经济学评价上均优于全国中位数据和同级外院，并在PIVAS调剂效能上优于全国中位水平。 |
| ABSTRACT： | OBJECTIVE To establish an integrated central pharmacy management model combining the inpatient pharmacy and the pharmacy intravenous admixture service （PIVAS）， and to evaluate its effectiveness and economic value in terms of operational cost composition， dispensing output， and dispensing efficiency.METHODS Through spatial integration， flexible staff scheduling， the application of intelligent equipment， and a dual prescription review system， the inpatient pharmacy and PIVAS were integrated， and an integrated management model was implemented. Operational data from the Fourth Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”） in 2023 were selected for analysis， with national median data and data from another hospital in the same region that still implemented a separate management model for the inpatient pharmacy and PIVAS serving as controls. The activity-based costing method was used to calculate operating costs. Dispensing output， dispensing efficiency， and unit activity cost were compared among the three. Cost-benefit analysis was further conducted by calculating the net benefit （NB） and the incremental cost-effectiveness ratio （ICER） for economic evaluation.RESULTS Under the integrated central management model， the total operational cost of our hospital’s central pharmacy was 3.968 3 million yuan， representing an 11.80% reduction compared with the external hospital’s pharmacy （4.499 0 million yuan）， with consumable costs and labor costs decreasing by 38.73% and 10.99%， respectively. The total prescription dispensing volume （3.613 4 million orders） was 43.58% higher than that of the external hospital’s pharmacy （2.516 7 million orders）. The daily dispensing volume per capita reached 471.41 medication orders， 3.5 times that of the external hospital’s pharmacy （135.20 medication orders）. The unit activity cost was 1.10 yuan， showing a 38.55% decrease relative to the external hospital’s pharmacy （1.79 yuan）. The NB was 755 200 yuan， and the ICER was －2.36. In terms of PIVAS operations， the daily dispensing volume per capita for general infusions （including antibacterial drugs） in our hospital was 50.83 sets， higher than the national PIVAS median （49.11 sets） and the external hospital pharmacy （36.14 sets）； the daily dispensing volume per capita for hazardous drugs was 0.86 sets， higher than the national median （0.70 sets） and the external hospital pharmacy （0.16 sets）.CONCLUSIONS The integrated central pharmacy management model established by our hospital achieved reduced operational costs and enhanced staff efficiency despite growing service volumes. Integrating the functions of both the inpatient pharmacy and the PIVAS， this model outperformed national medians and peer hospitals in dispensing output， dispensing efficiency， unit activity cost control， and economic evaluation， and surpassed the national median specifically in PIVAS dispensing efficiency. |
| 期刊： | 2026年第37卷第18期 |
| 作者： | 常兴；曾启；范银炜；马晶晶；包健安；邵丹妍 |
| AUTHORS： | CHANG Xing，ZENG Qi，FAN Yinwei，MA Jingjing，BAO Jian’an，SHAO Danyan |
| 关键字： | 中心药房;静脉用药调配中心;一体化管理;成本-效益分析 |
| KEYWORDS： | Central pharmacy;Pharmacy intravenous admixture service;integrated management;Cost-benefit analysis |
| 阅读数： | 1 次 |
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