對藥品采取不同的限量措施后單病種付費病例的用藥變化分析

李紀(jì)偉

摘要：目的? 分析單病種付費在對藥品采取不同的限量措施后，用藥情況的變化。方法? 選擇我院2017年5月～2018年8月各單病種付費的病例數(shù)，抽取前3位單病種付費病例數(shù)，估算其頻率標(biāo)準(zhǔn)誤，得出用其估計全院單病種付費用藥情況變化的可靠性;計算前3位單病種付費病例各時間段日均藥品總費用、采取不同的限量后與采取限量措施的藥品相同藥理作用的藥品的人均藥品使用頻度、DDC，并對結(jié)果進行分析。結(jié)果? 對前3位單病種付費的用藥情況估計全院單病種付費用藥情況是可靠的;對藥品采取不同的限量措施對單病種付費病例的日均藥品費用有影響;引進DDC較低的藥品，并對原藥品采取限量措施后，該類相同藥理作用的藥品的人均藥品使用頻度呈上升趨勢、DDC呈下降趨勢;對使用量較大的輔助、高價藥品采取限量措施后，該類相同藥理作用的藥品的人均藥品使用頻度呈上升趨勢、DDC呈下降趨勢;有針對性地對某一類藥品采取限量措施后，該類相同藥理作用的藥品的人均藥品使用頻度、DDC均呈下降趨勢。結(jié)論? 降低單病種付費的藥品費用需要將強合理用藥監(jiān)控，同時采取一些行政手段，對于降低單病種付費病例藥品費用是有效的。

關(guān)鍵詞：單病種付費; 藥品限量措施; DDC ;DDDS

中圖分類號：R197.3? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻標(biāo)識碼：A? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2019.06.047

文章編號：1006-1959（2019）06-0148-03

Abstract：Objective? To analyze the changes in medication use after a single disease type has been treated with different restrictions on drugs. Methods? The number of cases paid for each single disease in our hospital from May 2017 to August 2018 was selected. The number of the first three single-species paid cases was estimated， and the frequency standard error was estimated. The reliability of the changes in the use of drugs; calculate the total daily average drug cost of each of the first three single-species paid cases， and the frequency of drug use per capita， DDC， for drugs with the same pharmacological effects after taking different limits. And analyze the results. Results? It is estimated that the payment of the first three single-species drugs is reliable in the case of single-medical drugs. The different measures for drugs have an impact on the daily average drug costs of single-patient paid cases; the introduction of DDC is lower. After taking the limited measures for the original drugs， the frequency of per capita drug use of the drugs with the same pharmacological effects is on the rise， and the DDC is on the downward trend. After taking the limited measures for the auxiliary and high-priced drugs with large usage， the frequency of per capita drug use of drugs with the same pharmacological effects is on the rise， and DDC is on a downward trend. After targeted measures for certain types of drugs， the frequency of per capita drug use and DDC of drugs with the same pharmacological effects Both showed a downward trend. Conclusion? Reducing the cost of medicines for single disease requires strong and rational drug monitoring， and at the same time， some administrative measures are taken to reduce the cost of drugs for single-patient paid cases.