杭州地区公立医院实行药品“零差率”前后处方金额和数量的对比分析

发布时间：2018-03-03 10:42

本文选题：药品“零差率”　切入点：公立医院　出处：《中国药房》2017年02期 　论文类型：期刊论文

【摘要】：目的:分析药品"零差率"政策对公立医院处方金额和数量的影响,为药品政策的评估和持续改进提供参考。方法:采用回顾性分析方法,分别统计杭州地区7家省级医院和5家市县级公立医院实行药品"零差率"前后处方金额和处方数的变化以及对不同类别药品、不同科室和常见慢性病诊断的处方数和处方金额的影响。结果:实行药品"零差率"后,12家医院药品处方总金额增长率为16.51%,其中省级医院(18.20%)高于市县级医院(7.58%)。市县级医院的门诊处方总金额、处方总张数和平均处方金额均比"零差率"前增加,省级医院门诊处方总金额和平均处方金额均有所增加,而处方张数有所下降。抗恶性肿瘤药物的门诊处方金额占比由实行前的7.00%上升至9.10%,神经系统用药的住院处方金额占比由9.40%上升至11.20%,抗感染药物无论是门诊还是住院处方金额占比均下降10%以上。门诊处方总金额排名前10位科室中除肾内科和普通内科出现下降外,其他科室均有不同程度增加,平均处方金额增加幅度最大的是泌尿外科(16.89%),而下降幅度最大的是肾内科(-4.31%)。实行"零差率"后,诊断为高血压、糖尿病和高脂血症的平均处方金额和平均处方药品种数均有所上升。结论:药品"零差率"政策对省级和市县级医院用药带来的变化存在一定差异,对门诊和住院医师用药行为的影响也有所不同。
[Abstract]:Objective: to analyze the effect of the "zero difference rate" policy on the amount and quantity of prescriptions in public hospitals, and to provide a reference for the evaluation and continuous improvement of drug policy. The changes of prescription amount and number of prescriptions before and after the implementation of "zero difference rate" of drugs in 7 provincial hospitals in Hangzhou area and 5 public hospitals at county level in Hangzhou area were analyzed respectively, as well as the changes of prescriptions for different categories of drugs. Results: after the "zero difference rate" of drugs was carried out, the total increase rate of prescription sum in 12 hospitals was 16.51%, in which the provincial hospitals were 18.20%) higher than those in county level hospitals (7.58%). The total amount of outpatient prescriptions in county-level hospitals, The total number of prescriptions and the average amount of prescriptions were increased compared with those before "zero difference rate", and the total and average prescriptions of outpatients in provincial hospitals increased. However, the number of prescriptions decreased. The proportion of outpatient prescriptions for anti-cancer drugs increased from 7.00% to 9.10 before implementation, the proportion of hospital prescriptions for nervous system drugs increased from 9.40% to 11.20, and the proportion of anti-infective drugs in outpatient clinics and residents increased to 11.20. The proportion of prescriptions in hospitals decreased by more than 10%. In the top 10 departments, except for renal medicine and general internal medicine, the total amount of prescriptions in outpatient departments decreased. Other departments increased in varying degrees. The largest increase in the average amount of prescriptions was in urology, while the biggest decrease was in renal medicine. After the "zero difference rate" was implemented, hypertension was diagnosed. The average prescription sum and the average number of prescription drugs increased in diabetes mellitus and hyperlipidemia. Conclusion: there are some differences in the changes of drug use brought by the policy of "zero difference rate" between provincial and county hospitals. The effects on drug use behavior of outpatients and residents are also different.
【作者单位】：杭州师范大学医学院附属余杭医院药剂科;
【分类号】：R95

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