2012版《国家基本药物目录》施行后某院医保患者基本药物使用情况分析

目的:为促进基本药物合理使用和提高其使用率提供参考。方法:采用回顾性分析方法,对某大型三甲医院2013年上、下半年2012版《国家基本药物目录》实施前后医保患者基本药物使用金额、数量、人次及所占比例等进行统计、排序、分析。结果:该院2013年上半年医保患者基本药物的使用数量所占比例为42.23%,使用人次所占比例为47.47%,使用数量达到原卫生部对三级医院该指标的要求,但使用金额所占比例(11.80%)偏低;2013年下半年与上半年比较,各项指标均有所提升,差异均有统计学意义(P<0.05),但金额比例仍未达标。该院基本药物使用占主导地位的为西药品种,其中调节水、电解质及酸碱平衡药和心血管疾病用药、营养支持类药位居前列;2013年下半年与上半年比较,排名前5位的基本药物品种基本不变,但其使用金额、使用数量、使用人次占总体的比例绝大多数有所下降,且除0.9%氯化钠注射液和注射用血栓通(冻干)的金额比例外,其他各项指标数据差异均有统计学意义(P<0.05或P<0.01)。结论:2012版《国家基本药物目录》的实施有利于提高基本药物使用率,该院医保患者基本药物品种及其使用情况基本符合国家对三甲医院的要求,但还需采取积极宣教、绩效考核等措施进一步促进基本药物合理使用。

Utilization of National Essential Medicine in Medicare Patients in a Hospital after the Implementation of 2012 Edition of National Essential Medicine List

OBJECTIVE： To provide reference for promoting rational use and utilization ratio of essential medicines. METH- ODS： Before and after the implementation of new edition of National Essential Medicine List, by retrospective analysis, the utiliza- tion of essential medicine in Medicare patients from a third-grade class A hospital in first and second half year of 2013 were statisti- cally analyzed in terms of consumption sum, quantity, person-time and proportion, etc. RESULTS： For the use of essential medi- cine in Medicare patients, in the first half year, except for the consumption sum ratio （11.8%） was low, the quantity ratio （42.23%） and the person-time ratio （47.47%） met the target of former Ministry of Health. Compared with the first half year, in the second half year, these indicators had been improved; there was statistical significance （P〈0.05）, but consumption sum ratio had not yet reached the standard. The species of essential medicine was dominated by western medicine in the hospital, drugs fro regulating water-electrolyte and acid-base balance, drugs for cardiovascular disease and drugs for nutritional support took up the front place. Compared with the first half year, in the second half year, the top 5 essential medicines changed a little in category, but the consumption sum ratio, quantity ratio and person-time ratio of essential medicines were all declined; except for consump- tion sum ratio of 0.9% Sodium chloride injection and Xueshuantong for injection （freeze-drying）, the difference of the other indica- tors was statistically significant （P〈0.05 or P〈0.01）. CONCLUSIONS： The implementation of new edition of National Essential Medicine List is beneficial to improve the utilization ratio of essential medicine. The types and utilization of essential medicines in Medicare patients in the hospital is in line with national requirements, but also need to take active measures such as positive educa- tion and performance appraisal to improve rational use of essential med