摘要
目的:依托疾病诊断相关分组(diagnosis related groups,DRG)数据,探讨重点监控药品精细化管理新模式,为持续改进费用管理模式作铺垫。方法:比较武汉市第一医院(以下简称“我院”)实施重点监控药品管控前(2018年9—11月)、管控后(2019年9—11月)住院患者重点监控药品使用情况,并选取排序靠前的DRG组进行入组例数、次均费用和药品费用等的统计学分析,比较管控前后的费用差异。结果:管控后,我院重点监控药品费用占科室药品费用的比例明显降低,尤其是神经内科、肾病内科。其中,管控后BR23组(脑缺血性疾病,伴合并症与伴随病)、BX23组(周围神经疾病,伴合并症与伴随病)药品费用均较管控前大幅度降低,差异均有极显著统计学意义(P<0.001);管控后LR11组(肾衰竭,伴重要合并症与伴随病)药品费用明显降低,与管控前的差异有统计学意义(P<0.05)。结论:基于DRG实施重点监控药品精细化管理,在一定程度上规范了我院重点监控药品的用药合理性,为持续优化费用管理模式提供了参考。
OBJECTIVE:To probe into the new model of delicacy management of key monitoring drugs based on diagnosis related groups(DRG)data,so as to pave the way for continuous improvement of the expense management model.METHODS:To compare the application of key monitoring drugs on hospitalized patients before(from Sept.to Nov.2018)and after(from Sept.to Nov.2019)the implementation of key monitoring drugs control the First Hospital of Wuhan(hereinafter referred to as“our hospital”),to select the top DRG group for statistical analysis of the number of cases,average cost per time and drug cost,and to compare the expense difference before and after control.RESULTS:After the control of key monitoring drugs,the proportion of expense of key monitoring drugs accounted for total drugs in clinical departments was significantly decreased,especially in the departments of neurology and nephrology.Among them,the drug expenses in BR23 group(cerebral ischemic disease,accompanied with comorbidities and concomitant diseases)and BX23 group(peripheral nerve disease,accompanied with comorbidities and concomitant diseases)were greatly decreased compared with that of before the control of key monitoring drugs,with statistically significant difference(P<0.001);and the drug expense in LR11 group(renal failure,accompanied with comorbidities and concomitant diseases)was significantly decreased,with statistically significant difference(P<0.05).CONCLUSIONS:The implementation of delicacy management of key monitoring drugs based on DRG has standardized the rational application of key monitoring drugs in our hospital in a certain degree,which has provided a reference for continuous optimization of the expense management model.
作者
杨香瑜
陈辰
胡松
张瑶
张韶辉
YANG Xiangyu;CHEN Chen;HU Song;ZHANG Yao;ZHANG Shaohui(Dept.of Pharmacy,the First Hospital of Wuhan,Hubei Wuhan 430022,China;Dept.of Medical Service,the First Hospital of Wuhan,Hubei Wuhan 430022,China)
出处
《中国医院用药评价与分析》
2021年第5期612-615,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
湖北省卫生健康委科研项目(WJ2021M005)
湖北省临床药学重点专科建设项目(鄂卫通〔2019〕49号)。
