基于DEA方法的华法林抗凝分级管理模式的效率评价

目的:通过小范围的临床实践,使用数据包络分析(data envelopment analysis,DEA)方法对基于全程化抗栓药学服务模式的华法林抗凝管理工作效率进行评价。方法:选取2021年7-12月南京大学医学院附属鼓楼医院心胸外科瓣膜置换术后使用华法林抗凝的患者。将患者分为实验组和对照组,实验组由临床药师利用基于分级管理的全程化抗栓药学服务模式进行抗凝管理和药学监护,对照组由临床药师按照无差别监护模式进行抗凝管理和监护,记录2种模式下药师工作内容和工作成效,通过DEA方法分析比较2种抗凝管理模式的效率。结果:研究最终纳入服用华法林的患者233人(实验组116人,对照组117人),实验组的单位患者管理时间显著减少(27.8±9.7)min vs.(34.8±11.4)min]。经模型计算后,实验组的总体效率值为1,说明其投入和产出最优,且效率高于对照组。结论:全程化抗栓药学服务模式下药师管理单位抗凝患者需要的时间更少,管理效率更高。

Efficiency evaluation of warfarin anticoagulant hierarchical management mode based on DEA method

OBJECTIVE To evaluate the efficiency of warfarin anticoagulant management based on the whole-process antithrombotic pharmaceutical care model by using data envelopment analysis(DEA)method in a small-scale clinical practice.METHODS Patients who received warfarin anticoagulation after valve replacement in the Department of Cardiothoracic Surgery,Nanjing Drum Tower Hospital from July 2021 to December 2021 were enrolled.The patients were divided into experimental group and control group.The experimental group was administered anticoagulant management and pharmaceutical care by clinical pharmacists using the whole-process antithrombotic pharmaceutical care model based on hierarchical management,and the control group was administered anticoagulant management and care by clinical pharmacists in accordance with the undifferentiated care model.Record the work content and effectiveness of pharmacists under the two modes.The efficiency of the two anticoagulant management modes was analyzed and compared by DEA method.RESULTS A total of 233 patients(116 in the experimental group and 117 in the control group)took warfarin,and the management time per patient in the experimental group was significantly reduced(27.8±9.7) min vs.(34.8±11.4) min].After model calculation,the overall efficiency value of the experimental group is 1,indicating that its input and output had reached the optimal,and the efficiency was higher than that of the control group.CONCLUSION Under the whole-process antithrombotic pharmaceutical care model,pharmacists’ management units need less time for anticoagulant patients and have higher management efficiency.