Page 22 - 《中国药房》2025年7期

重点监控药品合理用药管理指标体系的构建
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张明雄 ，秦婉莹，黄 健，王 丹，李 莉，卜莹慧，颜 铭，李珂佳（昆明医科大学第二附属医院药学部，昆明
650033）

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2025）07-0784-05
DOI 10.6039/j.issn.1001-0408.2025.07.03

摘 要 目的 构建重点监控药品合理用药管理指标体系，为医疗机构重点监控药品的管理提供参考。方法 通过文献调研初步
拟定重点监控药品合理用药管理指标框架；采用改进德尔菲法，选择20名经验丰富的药学、医务、医保和财务专家，进行2轮问卷
咨询，根据专家积极系数、权威系数、意见集中程度和协调程度，确定最终指标，建立医疗机构重点监控药品合理用药管理指标体
系。结果 2轮咨询中，专家积极系数均为100%；一、二、三级指标的专家权威系数分别为0.89、0.86和0.87，重要性评分专家协调
系数分别为 0.300（P＜0.05）、0.125（P＜0.05）和 0.139（P＜0.05）。所有指标的重要性评分均值均大于 3.5 分，满分比为 35%～
100%，变异系数除三级指标“重点监控药品采购品规数”为0.26外，其余均不大于0.25。根据专家咨询结果，最终建立包含2个一
级指标（药品采购使用和合理用药）、5个二级指标（可及性、经济性等）、20个三级指标（重点监控药品采购品规数、重点监控药品
费用增幅等）的重点监控药品合理用药管理指标体系。结论 本研究建立的医疗机构重点监控药品合理用药管理指标体系具有较
高的可靠性和较强的可操作性，可作为医疗机构重点监控药品管理的参考依据。
关键词 重点监控药品；改进德尔菲法；合理用药；指标体系

Construction of management index system for rational drug use of key monitoring drugs

ZHANG Mingxiong，QIN Wanying，HUANG Jian，WANG Dan，LI Li，BU Yinghui，YAN Ming，LI Kejia（Dept.
of Pharmacy， the Second Affiliated Hospital of Kunming Medical University， Kunming 650033， China）

ABSTRACT OBJECTIVE To establish management index system for rational drug use of key monitoring drugs， and provide
reference for the management of key monitoring drugs in the hospitals. METHODS First， the management index system for
rational drug use of key monitoring drugs was drafted by collecting the evidence from related medical literature. Next， using a
modified Delphi method， twenty experienced experts from the fields of pharmacy， medical practice， healthcare insurance， and
finance were selected to participate in two rounds of questionnaire consultations. Based on the expert enthusiasm coefficient，
authority coefficient， degree of opinion concentration， and degree of coordination， the final indicators were determined to establish
a management index system for rational drug use of key monitored drugs in medical institutions. RESULTS The expert enthusiasm
coefficients reached 100% in both rounds of consultation. In first-level， second-level and third-level indicators， the authority
coefficients of experts were 0.89， 0.86 and 0.87， and coordination coefficients of the experts in importance score were 0.300 （P＜
0.05）， 0.125 （P＜0.05） and 0.139 （P＜0.05）， respectively. The average score for the importance of all indicators reached over
3.5， in which the full score ratio ranged from 35% to 100%. Except that the variation coefficient of a third-level indicator “number
of specifications purchased for key monitored drugs” was 0.26， the variation coefficients of rest indicators were less than or equal
to 0.25. Based on the results of expert consultation， final version of the management index system established in this study，
including two first-level indicators （drug procurement and use， and rational drug use）， five second-level indicators （such as the
accessibility， cost-effectiveness） and twenty third-level indicators （such as the number of specifications purchased for key
monitored drugs， the increase in the cost of key monitored drugs）. CONCLUSIONS The management index system established in
this study possesses high reliability and strong operability， and
Δ 基金项目 国家卫生健康委医院管理研究所医疗质量（循证）管
理研究项目（No.YLZLXZ23G049） may provide a reference for the management of key monitoring
＊第一作者 副主任药师。研究方向：药事管理及慢病患者用药管 drugs in the hospitals.
理。E-mail：zmx354792@163.com KEYWORDS
# 通信作者 副主任药师，博士。研究方向：药事管理、临床药学。 key monitoring drugs； modified Delphi
E-mail：taxol2000@126.com method； rational drug use； index system

· 784 · China Pharmacy 2025 Vol. 36 No. 7 中国药房 2025年第36卷第7期