| 唐景财,朱钊铭,秦柳霄,蒋红云,徐宏珍,余琴.临床药师在DRG背景下参与神经内科药事精细化管理的实践探索[J].中国药事,2024,38(5):588-593 |
| 临床药师在DRG背景下参与神经内科药事精细化管理的实践探索 |
| Exploring the Practice of Clinical Pharmacists Participating in FineManagement of Neurology Pharmacy Under the Background of DRG |
| 投稿时间：2023-10-09 |
| DOI：10.16153/j.1002-7777.2024.05.011 |
| 中文关键词: 临床药师 疾病诊断相关分组 神经内科 药事 精细化管理 |
| 英文关键词: clinical pharmacists DRG neurology pharmacy fi ne management |
| 基金项目:桂林市科技计划项目（编号 20210104Z）；广西壮族自治区卫生健康委员会计划课题（编号 Z20211561） |
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| 中文摘要: |
| 目的：探讨临床药师在疾病诊断相关分组（DRG）背景下参与神经内科药事精细化管理的成效。方法：选取桂林市人民医院神经内科2021-2022年进入DRG病组的出院患者为研究对象，比较临床药师参与神经内科药事精细化管理前（2021年）和干预后（2022年）患者的主要DRG指标及药事管理指标变化情况；对入组病例数排名前5位的重点DRG病组进行费用分析；对DRG病组中住院费用超过标杆医院2倍支付标准的病例进行用药合理性评价。结果：干预后，神经内科病例组合指数升高，费用消耗指数、时间消耗指数、次均住院费用和平均住院日均较干预前显著降低（P＜0.05）；药占比、辅助药占比、次均药费较干预前显著降低（P＜0.05）。在入组例数排名前5位的DRG病组中，BR23、BR21、BM19、BX29病组次均住院费用和次均药品费用均较干预前显著下降（P＜0.05）。临床药师对DRG超支病组进行干预后，超支率、不合理率显著下降（P＜0.05）。结论：临床药师基于DRG参与神经内科药事精细化管理，有助于提升临床科室医疗质量、服务效率、合理用药水平，为推进DRG付费改革提供参考。 |
| 英文摘要: |
| Objective: To explore the effect of clinical pharmacists participating in the fine management ofneurology pharmacy under the background of DRG (Diagnosis Related Groups). Methods: The dischargedpatients who entered the DRG disease groups in the Department of Neurology of Guilin People's Hospital from2021 to 2022 were selected as the research objects. The changes of main DRG indexes and pharmaceuticalmanagement indexes of patients before (2021) and after (2022) intervention of clinical pharmacists participatingin the fi ne management of neurology pharmacy were compared. Cost analysis was carried out for the key DRGgroups with the top 5 in the number of enrolled cases. The rationality of medication was evaluated in the DRGdisease groups with hospitalization expenses exceeding 2 times the payment standard of the benchmark hospital.Results: After intervention, the case mix index of neurology department increased, and the cost consumption index, time consumption index, average hospitalization expenses and average hospitalization days weresignifi cantly lower than those before intervention (P＜0.05). The proportion of drugs, the proportion of auxiliarydrugs and the average drug expenses per time were signifi cantly lower than those before the intervention (P＜0.05).Among the top 5 DRG disease groups, the average hospitalization expenses and average drug expenses per time ofBR23, BR21, BM19 and BX29 disease groups were signifi cantly lower than those before intervention (P＜0.05).After clinical pharmacists intervened in DRG overspending cases, the overspending rate and unreasonablerate decreased significantly (P＜0.05). Conclusion: Clinical pharmacists participate in the fine managementof neurology pharmacy based on DRG, which is helpful to improve the medical quality, service effi ciency andrational drug use level of clinical departments, and provides reference for promoting DRG payment reform. |
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