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·药师与药学服务·

        基于成本-效益分析的医疗机构药学服务经济价值探讨                                                            Δ


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        孔令希 ,王红梅 ,彭 敏 ,邱 峰 ,杨佳丹 ,单雪峰 (1.重庆医科大学附属第一医院药学部,重庆 400016;
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        2.重庆市医药科技学校,重庆 400062)
        中图分类号 R95;R956          文献标志码 A          文章编号     1001-0408(2022)14-1769-07
        DOI  10.6039/j.issn.1001-0408.2022.14.19
        摘  要   目的 系统评价采用成本-效益分析法评估医疗机构药学服务经济性的相关研究,以期为相关政策决策提供循证依据,并
        为今后开展药学服务经济性评价提供方法学参考。方法 系统检索PubMed、Embase、Cochrane图书馆、中国生物医学文献数据库、
        万方数据、维普网、中国知网及相关网站中采用成本-效益分析法评估医疗机构药学服务经济性的研究,由2名研究人员根据“综合
        卫生经济评价报告标准清单”独立筛选研究,提取数据,并对纳入研究的质量进行评分和描述性系统评价。结果 纳入了来自17个
        国家的46项研究,以美国(21.74%)、中国(19.57%)、法国(8.70%)居多。46篇文献的平均得分为14.30分,其中1篇文献的报告质
        量为优秀,5篇为良好,25篇为合格,15篇为不合格。有25项研究方案类型为前瞻性研究;纳入文献涉及的药学服务类型以药学
        监护居多(60.87%),其次是处方审核(23.91%),药物重整(8.70%)和药学门诊(6.52%)较少。纳入研究结果显示,药学服务的中
        位成本-效益比为5.05(3.08,11.28)。 结论 药学服务具有较好的经济价值,药师在节约医疗资源方面发挥了重要作用,但现有研
        究的设计水平和报告质量还有待改善。
        关键词 药学服务;成本;成本-效益;经济学评价;质量评估

        Discussion on economic value of pharmaceutical care in medical institutions based on cost-benefit analysis
        KONG Lingxi ,WANG Hongmei ,PENG Min ,QIU Feng ,YANG Jiadan ,SHAN Xuefeng (1. Dept. of
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        Pharmacy,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;2. Chongqing
        Pharmaceutical Science Technology School,Chongqing 400062,China)
        ABSTRACT    OBJECTIVE To evaluate related researches about the cost-benefit of pharmaceutical care in medical institutions
        with cost-benefit analysis,in order to provide evidence-based basis for related policy decisions and provide methodological
        reference for the cost-benefit evaluation of pharmaceutical care in the future. METHODS Retrieved from PubMed,Embase,the
        Cochrane Library,CBM,Wanfang database,VIP and CNKI,cost-benefit analysis was used to evaluate the researches about the
        cost-benefit of pharmaceutical care in medical institutions. Two researchers independently screened the research and extracted data
        according to the“Consolidated Health Economic Evaluation Reporting Standards Checklist”. The quality of included studies was
        scored and evaluated systematically. RESULTS A total of 46 studies from 17 countries were included. Most of them came from the
        United States(21.74%),China(19.57%)and France(8.70%). Average score of 46 literature was 14.30,of which 1 literature
        was excellent,5 literature were good,25 literature were qualified and 14 literature were unqualified. There were 25 research
        protocols of prospective study type;the type of pharmaceutical care involved mostly was pharmaceutical monitoring(60.87%),
        followed by prescription review(23.91%),medication reconciliation(8.70%)and outpatient pharmacy(6.52%)were less. The
        median cost-benefit ratio of pharmaceutical care was 5.05 (3.08,11.28). CONCLUSIONS Pharmaceutical care shows good
        economic value,and pharmacists have played an important role in saving medical resources,but the design level and report quality
        of the existing studies need to be improved.
        KEYWORDS    pharmaceutical care;cost;cost-benefit;economic evaluation;quality evaluation

            随着我国医疗卫生体制改革的不断深化,医院药学                        “在保障药品供应的基础上,以重点加强药学专业技术
        服务模式经历了“两个转变”,即从“以药品为中心”转变                         服务、参与临床用药为中心”。药师通过药学服务来改
        为“以患者为中心”,从“以保障药品供应为中心”转变为                         善患者生命质量的理念已被广大患者及临床医疗团队
                                                           所接受。根据《医疗机构药学服务规范》(2019 版)中的
           Δ 基金项目 重庆市科卫联合医学科研项目(No.2020MSXM120)
                                                           定义,药学服务是指医疗机构药师为保障患者用药安
           *第一作者 主管药师,硕士。研究方向:药理学、药物经济学。电
                                                           全、优化患者治疗效果和节约治疗费用而进行的相关服
        话:023-88955540。E-mail:klingxi@126.com
                                                                                                 [1]
           # 通信作者 副主任药师,博士。研究方向:药物经济学、药事管                  务,旨在发现和解决与患者用药相关的问题 。可见,经
        理。E-mail:83846674@qq.com                           济价值已是我国药学服务工作开展的题中之义。2021

        中国药房    2022年第33卷第14期                                            China Pharmacy 2022 Vol. 33 No. 14  ·1769 ·
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