北京市医疗保险住院患者醒脑静注射液应用情况调查与分析

目的:评价北京市“医保”住院患者醒脑静注射液的应用状况,为合理用药和“医保”支付提供参考。方法:随机抽取2004年北京市医疗保险信息数据库中5家不同级别医院应用醒脑静的住院病例,调查其适应证、剂量、疗程、不良反应等。结果:共调查病例676例,应用醒脑静的前10种适应证中18．0％与药品说明书不符,17．5％缺乏临床研究证据支持;平均单次剂量为(27．9±9．0)mL,高于药品说明书规定的常用量和临床研究中的常用量;平均疗程14．6d,有20．9％超过20d;合并用药有抗栓药(13．3％)、活血化淤中药(12．7%)等。结论:“医保”患者醒脑静注射液应用存在与药品说明书规定的适应证、给药剂量及现有临床研究证据不符的情况。

Use of Xingnaojing Injection in Medical Insurance Inpatients in Beijing:Survey and Analysis

OBJECTIVE: To evaluate the use of Xingnaojing Injection in medical insurance inpatients in Beijing city so as to provide reference for rational drug use and medical insurance billing.METHODS: Inpatient cases using Xingnaojing Injection in 5 Beijing hospitals of different levels were randomly sampled from the 2004 Beijing Medical Insurance Database,and analyzed in terms of indication, dosage, treatment course and ADR.RESULTS: A total of 676 cases were sampled with more than 25 kinds of indications,and among the top 10 indications, 18.0% were inconsistent with the instruction,and 17.5% were in lack of evidence support such as randomized controlled trials.Individual dose of Xingnaojing Injection was(27.9±9.0)mL, which was higher than the usual dose described by the instructions and clinical trials.The mean treatment course of Xingnaojing Injeciton was 14.6 days,with 20.9% exceeding 20 days.Drugs used in combination with Xingnaojing Injection included anti - thrombosis agents( 13.3% ) and traditional Chinese medicines with the action of promoting blood circulation and removing blood stasis (12.7%) .CONCLUSION: The use of Xingnaojing injection in medical insurance patients was not consistant with the instruction or evidence supported by clinical trials.