摘要
目的分析疾病诊断相关分组(DRGs)付费模式下某院处方点评联合处方前置审核规范质子泵抑制剂(PPIs)注射剂的使用效果。方法抽取医院2021年3月至4月(500份)、5月至6月(300份)、9月至10月(300份)DRGs付费模式下使用PPIs注射剂患者的病历,并开展处方点评;2021年9月引入处方前置审核系统,对使用PPIs注射剂住院医嘱开展处方前置审核。比较2021年3月至12月每月PPIs注射剂的使用率、使用金额、使用频度、使用强度,分析处方点评及处方前置审核后的PPIs注射剂不合理使用效果。结果开展处方点评后,PPIs注射剂使用率由2021年3月的79.12%降至12月的14.47%,使用频度由47429降至12496,使用强度由70.35降至19.08,使用金额由112.59万元降至23.64万元,不合理使用率由72.60%降至13.00%;PPIs注射剂不合理用药804例次,主要包括遴选药物不适宜384例次(47.76%)和用法用量不适宜240例次(29.85%)。2021年9月至12月,处方前置审核系统其拦截不合理医嘱471例,主要为用法用量不适宜(23.78%,112/471)和用药疗程不适宜(76.22%,359/471)。结论DRGs付费模式下处方点评联合处方前置审核促进了PPIs注射剂的合理使用,降低了药品费用,减轻了患者的经济负担,提升了用药安全。
Objective To analyze the effect of prescription comment combined with pre-prescription review on standardizing the use of proton pump inhibitors(PPIs)injections in a hospital under the diagnosis-related groups(DRGs)payment model.Methods Under the DRGs payment model,the medical records containing PPIs injections were selected from March to April 2021(500 cases),May to June 2021(300 cases),and September to October 2021(300 cases)to conduct prescription comment.In September 2021,a prescription pre-review system was introduced to conduct prescription pre-review for inpatient medical orders containing PPIs injections.The monthly usage rate,consumption sum,defined daily doses(DDDs),antibiotics use density(AUD),and irrational usage rate of PPIs injections from March to December 2021 were compared,and the irrational use of PPIs injections after prescription comment and pre-prescription review was analyzed.Results After implementing the prescription comment,from March to December 2021,the usage rate of PPIs injections decreased from 79.12%to 14.47%,the DDDs decreased from 47429 to 12496,the AUD decreased from 70.35 to 19.08,the consumption sum decreased from CNY 1125900 to CNY 236400,the irrational use rate decreased from 72.60%to 13.00%.The 804 cases of irrational use of PPI injections mainly included inappropriate drug selection(384 cases,47.76%)and inappropriate usage and dosage(240 cases,29.85%).From Semptember to December 2021,the prescription pre-review intercepted 471 cases of irrational medical orders,mainly due to the inappropriate usage and dosage(23.78%,112/471),and the inappropriate medication duration(76.22%,359/471).Conclusion Prescription comment combined with pre-prescription review under the DRGs payment model have promoted the rational use of PPIs injections,have reduced drug consumption sum and patients'economic burden,and have improved patients'medication safety.
作者
韩静文
程娟
吴妍
张哲弢
李会婷
史天陆
HAN Jingwen;CHENG Juan;WU Yan;ZHANG Zhetao;LI Huiting;SHI Tianlu(The First Affiliated Hospital of USTC·Anhui Provincial Hospital,Hefei,Anhui,China 230036)
出处
《中国药业》
CAS
2023年第13期26-30,共5页
China Pharmaceuticals
基金
安徽省市场监督管理局安徽省科学技术厅质量基础设施标准化专项项目[2022MKS06]。
关键词
疾病诊断相关分组
质子泵抑制剂
处方点评
处方前置审核
diagnosis-related groups
proton pump inhibitors
prescription comment
prescription pre-review
