Page 121 - 《中国药房》2022年1期

跨区域点评制度对二级综合医院合理用药的促进作用 Δ

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刘 静 ，蔡瑞君，李 娟，曾秀琴，谢希晖，王 丹，茹爱忠（酒泉市人民医院药学部，甘肃 酒泉 735000）
中图分类号 R95 文献标志码 A 文章编号 1001-0408（2022）01-0111-05
DOI 10.6039/j.issn.1001-0408.2022.01.19

摘 要 目的 探讨跨区域点评制度的建立对二级综合医院合理用药的作用，促进医院合理用药水平的提升。方法 通过酒泉市卫
生健康委的行政支持，联合酒泉市医疗联合体内5家二级综合医院成立酒泉市合理用药点评培训中心，并建立跨区域点评制度，
在5家二级综合医院之间相互交叉开展处方、医嘱点评工作。收集本课题方案实施前（2020年4－6月）、方案实施后（2020年7－9
月）5家二级综合医院的处方共1 500张、住院医嘱900份，考察方案实施前后各医院合理用药指标及处方、医嘱点评结果的变化。
结果 方案实施后，除1家医院外，其余入组医院药占比均不同程度地下降，最高下降幅度达22.56％。与方案实施前比较，入组医
院方案实施后门急诊处方用药合理率平均提高了5.72％，医院医嘱用药点评合理率平均提高了10.10％（P＜0.05）；门诊患者抗菌
药物使用率平均下降了14.45％，住院患者抗菌药物使用率平均下降了7.98％，抗菌药物使用强度平均下降了25.19％。结论 通过
建立跨区域点评制度，可以促进各医疗机构加强对处方点评工作的重视，以有效提高医疗机构药师的处方点评水平，对推动区域
内医疗机构处方合理用药水平的提高有促进作用；但目前仍存在制度覆盖面不完全、工作经验不足、信息化程度滞后、药师水平参
差不齐、行政职能部门考核监管力度不够等问题。
关键词 处方点评；跨区域点评；二级综合医院；合理用药；干预

Promotion effects of trans-regional review system on rational drug use in second-grade general hospital
LIU Jing，CAI Ruijun，LI Juan，ZENG Xiuqin，XIE Xihui，WANG Dan，RU Aizhong（Dept. of Pharmacy，Jiuquan
Municipal People’s Hospital，Gansu Jiuquan 735000，China）

ABSTRACT OBJECTIVE To explore the role of the establishment of the trans-regional review system on rational drug use in
second-grade general hospital，and to promote the rational drug use. METHODS With the administrative support of Jiuquan Health
Commission，5 second-grade general hospitals in Jiuquan Medical Association jointly established Jiuquan Rational Drug Use
Review Training Center. A trans-regional review system was established to carry out cross-review of prescriptions and medical
orders among 5 second-grade general hospitals. Totally 1 500 prescriptions and 900 medical records were collected from 5
second-grade general hospitals before（April to June，2020）and after（July to September，2020）the implementation of the project.
The changes of rational drug use indicators，the results of prescriptions and medical order review were investigated before and after
the implementation of the project. RESULTS After the implementation of the project，except for one hospital，the proportion of
drugs in other hospitals decreased to varying degrees with the highest decline rate of 22.56％ . Compared with before the
implementation of the project，reasonable rate of outpatient and emergency prescription review increased by 5.72％ averagely and
the reasonable rate of medical order review increased by 10.10％（P＜0.05）. The average utilization rate of antibiotics in outpatients
decreased by 14.45％，the average utilization rate of antibiotics in inpatients decreased by 7.98％，and the average use intensity of
antibiotics decreased by 25.19％. CONCLUSIONS Through the establishment of trans-regional review system，medical institutions
can be forced to pay more attention to prescription review，effectively improve the prescription review of pharmacists in medical
institutions，and promote the rational use of drugs in medical institutions in the region. However，there are still some problems，
such as incomplete system coverage，insufficient work experience，lagging of informatization，uneven pharmacist level，and
insufficient assessment and supervision of administrative functional departments.
KEYWORDS prescription review；trans-regional review；second-grade general hospital；rational drug use；intervention

随着医药卫生体制改革的深入推进，医疗费用的过 关系，而如何降低医疗费用和保障用药安全越来越受到
快增长已成为一个严重的社会问题，这其中除与我国医 国家的关注。实施处方点评制度的目的在于通过点评
药政策不完善、医疗体系不健全等多方面因素有关外， 处方，从中发现存在的或潜在的问题，并采取相应的干
还与我国长期以来缺乏对医师处方的有效监督有直接 预措施，以规范医师用药行为、实现提高医疗质量的目

Δ 基金项目：酒泉市科技计划项目 的 。现阶段，由于各医疗机构对该项工作的重视程度
[1]
＊主任药师，硕士。研究方向：医院药学、临床药学。电话：0937-
不同、标准掌握不统一、合理用药监督管理手段缺乏等
6982068。E-mail：27650318@qq.com
原因，医疗机构间处方点评工作质量存在很大差异，医
# 通信作者：主任药师。研究方向：医院药学。电话：0937-
6982217。E-mail：jqsyyraz@163.com 疗机构不合理用药等问题仍较为突出。2018年，国家卫

中国药房 2022年第33卷第1期 China Pharmacy 2022 Vol. 33 No. 1 ·111 ·