摘要
目的:评价药学干预对儿童社区获得性肺炎(CAP)治疗的经济学影响。方法:以2014年出院的儿童CAP患者作为对照组,自2015年起对儿童CAP的治疗实施药学干预。自2017年每月遴选10例儿童CAP患者纳入干预组。评价药学干预前对照组与干预后的干预组患者各项经济学指标的差异,并分析医疗保险类别对各项指标的影响。结果:相比于对照组,干预组患者用药相关的经济学指标呈现如下变化:(1)药品总费用平均降低13.14%,药占比平均值下降2.41%,患者支付的药品总费用平均降低26.61%;(2)指南推荐药品费用平均增加18.29%,非《儿童社区获得性肺炎管理指南》(以下简称《指南》)推荐中成药费用平均降低15.06%;(3)《指南》推荐药占比平均值提高13.89%;(4)新农合患者的医疗总费用、患者支付的药品总费用2项指标,显著高于城镇居民医保患者。结论:药学干预可以提高医生遵从《指南》用药比例,显著降低儿童CAP患者的药品总费用和药占比。
Objective： To evaluate the economic effect of pharmaceutical intervention on children community acquired pneumonia（CAP）. Methods： Children CAP inpatients in 2014 were selected as control group, pharmaceutical intervention was given to children CAP since 2015. Each month, 10 cases of children CAP were included in intervention group in 2017. It assessed the differences of varied economic indexes for the intervention group before and after the pharmaceutical intervention and the effects of medical insurance category were analyzed. Results： Compared with the control group, the related economic indexes of intervention group showed the following changes： （1） the total cast of drugs decreased by 13.14%, the average proportion of drugs decreased by 2.41%, and the total cost of drugs paid by patients decreased by 26.61% on average; （2） the cost of recommended drug by the guideline increased by 18.29% on average, the average cost of Chinese medicines non-recommended by guideline was reduced by 15.06%; （3） the proportion of recommended drug by the guideline increased by 13.89%; （4） the children with new rural cooperative medical insurance paid much more in the total medical cost and drug fee, which were significantly higher than those of the urban children（P〈0.05）. Conclusion： Pharmaceutical intervention could promote pediatricians to follow the guideline for medicines, and reduce the total east and proportion of drugs paid by children with CAP significantly.
作者
姚利文
孙安修
YAO Li-wen;SUN An-xiu(Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu,225001,China)
出处
《中国卫生经济》
北大核心
2018年第9期58-60,共3页
Chinese Health Economics
关键词
儿童
社区获得性肺炎
药学干预
经济学指标
children
community acquired pneumonia
pharmaceutical intervention
economic index
