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以合理用药绩效管理促进医院高质量发展
发布人：yaot 发布时间：2023/2/1 11:31:42 浏览次数：935次
——郑婷婷 李锦 卞婧 张威 甄健存
【摘要】合理用药是保障医疗质量与安全的重要举措之一。通过设置合理用药绩效考核指标，管控重点药品涉及的科室及医生，审核处方、医嘱优化药物治疗方案，动态监测与超常预警异常用药，限制重点监控药品用量以及实时公示药品使用情况等一系列管控方法，2017年-2021年次均药品费用均保持在较低水平，处方合格率总体上升；2021年门急诊次均药品费用和住院次均药品费用均较2020年下降，处方合格率达99.05%，合理用药绩效指标整体完成情况良好，达到了预期目标。还需继续加大抗菌药物合理使用管理力度，强化临床药师实时审核医嘱，优化抗感染治疗方案等。
【关键词】合理用药；绩效指标；绩效管理
中图分类号：R197.323；R9文献标识码：B
To Promote the High Quality Development of Hospitals by Performance Management of Rational Drug Use/ZHENG Tingting,LI Jin,BIAN Jing,et al.//Chinese Health Quality Management，2022,29(12):47-50
Abstract Rational drug use is one of the important measures to ensure medical quality and safety. By a series of control method of setting the rational drug use performance appraisal index, controlling key drugs involved departments and doctors, reviewing the prescription and the doctor's advice to optimize drug therapy, dynamic monitoring and supernormal warning of abnormal medication, limiting dosage of monitored drugs and real-time publicizing the drug usage, the average drug cost per time was kept at a low level and the qualified rate of prescriptions increased overall from 2017 to 2021. In 2021, the average outpatient and emergency drug costs and hospitalization drug costs decreased compared with those in 2020. The qualified rate of prescriptions reached 99.05%, and the overall performance indicators of rational drug use were well completed, reaching the expected goal. It was also necessary to continue to strengthen the management of rational use of antibiotics, strengthen the real-time review of medical orders by clinical pharmacists, and optimize the anti-infection treatment plan.
Key words Rational Drug Use; Performance Indicators; Performance Management
Firstauthor's address Beijing Jishuitan Hospital, Beijing,100035, China
近年来，国家相关政策鼓励医疗机构进一步加强药事管理，旨在推进药品临床合理使用。2017年4月，原国家卫计委等7部委联合印发《关于全面推开公立医院综合改革工作的通知》，要求到2017年年底前4批试点城市公立医院药占比（不含中药饮片）总体下降到30%左右［1］。2019年，国务院办公厅《关于加强三级公立医院绩效考核工作的意见》进一步强化了绩效考核导向，将合理用药纳入三级公立医院绩效考核指标体系［2］。2020年，国家卫生健康委员会等6部委印发《关于印发加强医疗机构药事管理促进合理用药的意见的通知》，要求加强医疗机构合理用药管理和绩效考核，并将药物合理使用等相关指标纳入医疗机构及医务人员绩效考核体系［3］。
实行药品零差价政策后，医院用药越多，消耗成本和占用资金反而越多［4-5］。因此，进行合理用药绩效指标管控，降低药品成本成为医疗机构管理者面临的新课题。北京市某三甲医院基于前期研究［6-7］，探索出一套有效的合理用药绩效管理方法，有效控制了医院用药成本。
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