医保目录调整对我院神经内科神经保护药物使用的影响分析

目的通过调查药物使用情况,分析新的医保目录是否对合理用药、控制药费、疾病预后有积极意义。方法采用回顾性分析,纳入我院神经内科住院的脑血管病患者,其中2019年10-12月入院的患者为调整前组,2020年1-3月入院的患者为调整后组。统计患者基本情况、用药情况、治疗费用及预后情况并进行对比分析。结果调整后常用药物由6种降至4种,联合用药从83%降至30%,住院费用中位数由17 838.02元降至15 475.39元(P<0.01),药品费用中位数由2 460.66元降至776.86元(P<0.05);调整前后患者的NIHSS评分与ADL评分比较差异无统计学意义。结论在医疗保险品种改变后,患者联合用药与医疗费用均明显降低,但治疗结果未有明显变化,说明新医保政策的实施并未对治疗效果产生影响,对医保控费、临床合理用药有推进作用。

Analysis of the influence of the adjustment in medical insurance catalogue on the use of neuroprotective drugs in neurology department of our hospital

Objective To analyze whether the new catalogue is of positive significance for rational use of drugs,control of drug costs and disease prognosis by investigating the use of drugs.Methods A retrospective analysis was used to analyze the patients with cerebrovascular disease in the Department of Neurology in our hospital,among whom the patients hospitalized from October to December 2019 were in the pre-adjustment group and those from January to March 2020 were in the post-adjustment group.The general information,medication,treatment cost and prognosis of the patients were collected,compared and analyzed.Results After adjustment,the kinds of commonly used drugs decreased from 6 to 4,the rate of combined use of drugs decreased from 83%to 30%,and the median of hospitalization cost decreased from 17838.02 yuan to 15475.39 yuan(P<0.05);the median of drug cost decreased from 2460.66 yuan to 776.86 yuan(P<0.05).There was no significant difference in NIHSS score or ADL score before and after adjustment.Conclusion After the drug variety of medical insurance changes,the combined use of drugs and medical expenses of patients are significantly reduced,but the treatment results have not changed significantly,which shows that the implementation of the new medical insurance policy does not have an impact on the treatment effect,and has a role in promoting medical insurance cost control and rational clinical medication.