摘要
目的:研究和评价不同地区10家医院锁骨骨折手术病人的医疗费用结构及合理用药情况。方法:从全军合理用药监测网数据库中筛选符合纳入条件的病例。对数据进行整合和分析,得到药费占比、材料费占比、药品用量和金额等指标,并对不合理用药情况进行分析。结果:例均医疗费用与医院所在地区经济的发展水平(或物价水平)成正比。不同医院间例均医疗费用、药费占比、药品选择等方面存在显著差异。材料费是锁骨骨折行切开内固定术病人最主要的经济负担(总体材料费占比为59.7%),药费居其次(总体药费占比为18.7%)。骨科辅助用药、神经辅助用药和中药注射剂占总药费的35%,是不合理用药集中的领域。结论:体现医务人员价值的手术、麻醉、治疗、护理等费用占比较低。不同医院对同一病种的药品选择和用量差异显著,不合理用药问题比较突出。政府应通过改革医疗保险付费制度、医务人员薪酬制度,实施合理用药质控措施等逐步引导医疗机构合理用药,控制医疗费用过快增长。
Objective:To study and evaluate the composition of medical expense and the rational drug use in treatment of the patients with clavicular fracture in 10 hospitals of different regions.Methods:The medical records that met the inclusion and exclusion criteria were retrieved from the database of the Military Monitoring Network for Rational Use of Drugs.The proportion of drug cost and material cost,drug amount and sum of money were summarized and analyzed.Results:The average medical cost per patient was proportional to the cost level of the area where the hospital was located.There were significant differences in the average medical cost per patient,the proportion of drug cost and the drugs used to treat patients among different hospitals.Material cost was the heaviest economic burden for clavicular fracture patients treated with open internal fixation.The overall material cost accounted for 59.7%,and was followed by drug cost(18.7%).Orthopedics adjuvant drugs,neuro-adjuvant drugs and traditional Chinese medicine injections accounted for 35%of the total drug cost,and they constituted the main area of irrational drug use.Conclusion:The proportions of operation,anesthesia,treatment and nursing expense that reflected the value of medical staff were relatively low.There were significant differences in drug use in treatment of same diseases in different hospitals,indicating that the the problem of irrational drug use was quite prominent.The government should guide medical institutions to use drugs rationally and control the growth of medical expenses by further reforming the payment system of medical insurance and the salary system of medical personnel,so as to control the overgrowth of medical costs.
作者
边佳明
李勇
储藏
寇建行
韩旭
BIAN Jiaming;LI Yong;CHU Cang;KOU Jianhang;HAN Xu(Military Monitoring Network for Rational Use of Drugs,Department of Pharmacology,Seventh Medical Center of PLA General Hospital,Beijing 100700,China;Health Bureau of Logistics Support,Ministry of PLA Central Military Commission,Beijing 100036,China)
出处
《药学服务与研究》
CAS
2020年第2期116-121,144,共7页
Pharmaceutical Care and Research
关键词
合理用药
锁骨骨折
医疗费用
单病种
rational use of drugs
clavicular fracture
medical cost
single disease
