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DRGs-PPS下的临床药师参与股骨颈骨折临床路径的实施效果
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| 篇名： | DRGs-PPS下的临床药师参与股骨颈骨折临床路径的实施效果 |
| TITLE： | |
| 摘要： | 目的：探讨在疾病诊断相关组预付费制度（DRGs-PPS）下的临床药师参与股骨颈骨折临床路径的实施效果，为促进临床合理用药提供参考。方法：收集我院进入临床路径的股骨颈骨折患者作为研究对象。2015年1－12月的患者为对照组，入径52例，完成路径 41 例；2016年1－12月的患者为观察组，入径58例，完成路径46例。临床药师参与观察组患者的临床路径实施，对临床用药进行技术干预和行政干预，对照组未进行干预。观察两组患者住院时间、住院费用、药品费用及不良反应情况，并比较两组患者预防用抗菌药物、镇痛药、辅助用药、抗骨质疏松药、抗凝药等5类药物的合理性。结果：临床药师参与观察组临床路径实施后，两组患者住院时间和不良反应发生率比较，差异均无统计学意义（P＞0.05）；观察组患者的住院费用、药品费用显著低于对照组，差异均有统计学意义（P＜0.05）。观察组患者预防用抗菌药物的用药时间和费用、镇痛药的用药费用、辅助用药的用药时间显著低/短于对照组，抗骨质疏松药用药品种均显著多于对照组，差异均有统计学意义（P＜0.05）。结论：在DRGs-PPS下，临床药师参与股骨颈骨折临床路径的实施，在一定程度规范了我院骨科5类药物的用药合理性，确保骨科临床用药安全、有效、经济。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of clinical pharmacists participating in the implementation of clinical pathway under the condition of disease diagnosis related groups-prospective payment system （DRGs-PPS）， and to provide reference for promoting rational drug use in the clinic. METHODS： Patients with femoral neck fracture in the clinical pathway were collected from our hospital as research objects. The patient collected during Jan.-Dec. 2015 were included in control group （52 patients included， 41 patients completed） and those collected during Jan.-Dec. 2016 were included in observation group （58 patients included， 46 patients completed）. Clinical pharmacists participated in the implementation of clinical pathway in observation group， and provided technological intervention and administrative intervention. No intervention was performed in control group. Hospitalization time， hospitalization cost， drug cost and ADR were observed in 2 groups. The rationality of antibiotics for prophylactic use， analgesic drugs， adjuvant drugs， anti-osteoporosis drugs and anticoagulant were compared between 2 groups. RESULTS： After clinical pharmacists participating in the implementation of clinical pathway in observation group， there was no statistical significance in hospitalization time or the incidence of ADR between 2 groups （P＞0.05）； hospitalization cost and drug cost of observation group were significantly lower than those of control group， with statistical significance （P＜0.05）. Medication time and cost of antibiotics for prophylactic use， cost of analgesic drugs， medication time of adjuvant drugs in observation group were significantly shorter/lower than control group； type of anti-osteoporosis drugs was significantly more than control group， with statistical significance （P＜0.05）. CONCLUSIONS： Under DRGs-PPS， the participation of linical pharmacists participating in the implementation of femoral neck fracture clinical pathway can play an important role in regulating the clinical rational use of 5 kinds of drugs and ensuring the safety， effectiveness and economics of drug use. |
| 期刊： | 2017年第28卷第23期 |
| 作者： | 韩凤昭，李振知，杨文华 |
| AUTHORS： | HAN Fengzhao，LI Zhenzhi，YANG Wenhua |
| 关键字： | 临床路径；临床药师；股骨颈骨折；药学干预；疾病诊断相关组预付费制度 |
| KEYWORDS： | Clinical pathway； Clinical pharmacists； Femoral neck fracture； Pharmaceutical intervention； DRGs-PPS |
| 阅读数： | 723 次 |
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