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    通过FOCUS-PDCA法优化管理医院国家基本药物采购与使用

    Optimized Management of National Essential Drugs Procurement and Use in Hospital by FOCUS-PDCA Method

      摘要
    • 摘要: 目的 采用管理工具优化管理医院国家基本药物采购与使用。方法 调查南通大学附属医院的国家基本药物采购、配备和使用的情况，按FOCUS-PDCA法落实推进国家基本药物制度，将执行FOCUS-PDCA前后的各项指标进行比较分析。结果 实施FOCUS-PDCA后，国家基本药物遴选比为72.0%，国家基本药物采购率为49.8%，均高于实施FOCUS-PDCA前（P均<0.05）。实施FOCUS-PDCA后，门急诊、住院基本药物使用率64.8%，59.8%，国家基本药物使用金额占比23.2%，均高于实施FOCUS-PDCA前；药占比33.5%，低于实施FOCUS-PDCA前。实施FOCUS-PDCA后，门诊患者的次均就医费用、次均药品费用分别为（167.23±29.11），（105.89±23.14）元，均低于实施FOCUS-PDCA前；次均基本药物费用（36.35±13.90）元，高于实施FOCUS-PDCA前（P均<0.05）。实施FOCUS-PDCA后，住院患者的次均就医费用、次均药品费用分别为（5 742.55±834.09），（2 009.89±327.09）元，平均住院日为（9.6±2.7）d，均低于实施FOCUS-PDCA前；次均基本药物费用（466.39±90.12）元，高于实施FOCUS-PDCA前（P均<0.05）。实施FOCUS-PDCA后，国家基本药物处方点评的合理率为94.4%，高于实施FOCUS-PDCA前（P<0.05）。结论 实施FOCUS-PDCA可促进医院国家基本药物优先合理使用，具有一定的推广应用价值。

       

      Abstract: OBJECTIVE To optimize the management of national essential drug procurement and use by using management tool in hospital. METHODS The procurement, allocation and use of national essential drugs in Affiliated Hospital of Nantong University were investigated. The national essential drugs system was promoted according to FOCUS-PDCA method. The indexes before and after FOCUS-PDCA implementation were compared and analyzed. RESULTS After the implementation of FOCUS-PDCA, the national essential drugs selection ratio was 72.0%, and the national essential drugs procurement rate was 49.8%, which were higher than those before the implementation of FOCUS-PDCA (all P<0.05). After the implementation of FOCUS-PDCA, the utilization rate of national essential drugs in outpatient & emergency and hospitalization was 64.8% and 59.8%, and the national essential drug use amount accounted for 23.2%, which were higher than before the implementation of FOCUS-PDCA; the drug use rate was 33.5%, lower than before the implementation of FOCUS-PDCA. After the implementation of FOCUS-PDCA, the average medical expenses and drug costs of outpatients were (167.23±29.11), (105.89±23.14)yuan respectively, which were lower than those before the implementation of FOCUS-PDCA, and the average cost of essential drugs was (36.35±13.90)yuan, which was higher than that before the implementation of FOCUS-PDCA (all P<0.05). After the implementation of FOCUS-PDCA, the average medical expenses and drug expenses of inpatients were (5 742.55±834.09), (2 009.89±327.09)yuan respectively, the average length of stay was (9.6±2.7)d, which were lower than those before the implementation of FOCUS-PDCA, and the average cost of essential drugs was (466.39±90.12)yuan, which was higher than that before the implementation of FOCUS- PDCA(all P<0.05). After the implementation of FOCUS-PDCA, the rational rate of national essential drugs prescription review was 94.4%, which were higher than that before the implementation of FOCUS-PDCA(P<0.05). CONCLUSION The implementation of FOCUS-PDCA can promote preferential and rational use of national essential drugs in hospital, and has certain application value.

       

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