医疗保险住院患者免疫增强剂应用分析

目的:评价福州地区4家三级甲等医院住院患者免疫增强剂的应用情况。方法:调取福建省医疗保险管理中心铁路分中心4家三级甲等医院2010年2267份住院患者病历,按是否应用免疫增强剂、出院诊断分别统计住院人次、次均费用等指标,并分析免疫增强剂的联用情况。结果:应用免疫增强剂的住院次均费用为(24331.09±23745.02)元,显著高于未应用组(15980.43±18197.10)元(P<0.001);免疫增强剂应用于15类疾病,86.63%的患者应用1～2个品种;不同医院免疫增强剂应用率、次均费用、联用品种数、疾病谱有明显区别。结论:所调查医院的免疫增强剂存在不合理应用现象;用药监管有利于临床应用规范化;基本医疗保险经办机构应制定有针对性的措施引导合理用药。

Analysis of the Application of Immunoenhancer in Medicare Inpatients

OBJECTIVE： To evaluate the application of immunoenhancer in the inpatients from 4 Grade-Three-Class-A hospitals in Fuzhou. METHODS： Medical records of 2 267 inpatients were collected from 4 Grade-Three-Class-A hospitals in 2010. The inpatient cares-time and cost each time were calculated according to whether immunoenhancer was used or not and discharge diagnosis, and combined use of immunoerthancer was analyzed. RESULTS： The costs of hospitalization for those patients who used immunoenhancer were （24 331.09 ± 23 745.02） yuan each time, which were significantly higher than the unused group （15 980.43±18 197.10） yuan （P〈0.001）. Immunoenhancer was used for 15 disease categories. About 86.63% of patients used 1 or 2 varieties. Utilization ra- tio of different hospitals, average cost of immunoenhancer each time, the quantities of combined use and disease spectnma were ap- parently different. CONCLUSION： The use of immunoenhancer existed irrational situation. Medical supervision help to standardize the use of immunoenhancer. Basic medical insurance agencies should develop targeted measures to guide rational drug use.