摘要:目的:了解2007~2008年成都地区17家医院生物制品及生化药品的使用状况。方法:采用限定日剂量(DDD)的方法,对成都地区2007~2008年17家医院生物制品及生化药品的销售金额、用药频度(DDDs)等进行统计分析。结果:2007年、2008年成都地区17家医院生物制品及生化药品销售总额分别为7338万元、9786万元;分别占总销售额的4.83%、5.00%。销售金额进入总销售额排名前100位的生物制品及生化药品有:人血白蛋白、胸腺肽、丙种球蛋白、促白细胞生长素和环磷腺苷。环磷腺苷在生物制品及生化药品中的DDDs最高。结论:生物制品及生化药品的价格及供给对其临床使用有较大的限制。Abstract: Objective: To evaluate the current situation and the trend of biological products and biochemical drugs used in Chengdu city in 2007 to 2008. Methods: Consumption of biological products and biochemical drugs used in 17 hospitals of Chengdu city in 2007 to 2008 were analyzed by the way of sum DDD and DDDs ranking. Results: The total cost of the biological products and biochemical drugs used in Chengdu city in was 73.38 and 97.86 million yuan in 2007 to 2008, it accounted for 4.83% and 5.00% of the total cost. Human serum albumin, thymosin, gamma globulin, interleukin promoting growth hormone and adenosine cyclophosphate were the drugs in the first 100 cost list. The DDDs of adenosine cyclophosphate was highest among biological products and biochemical drugs. Conclusion: The cost and supply of biological products and biochemical drugs were great limitations of their clinical application.
目的:分析本院住院部麻醉药品应用的现状及趋势,并作客观评价。方法:对2005~2008年本院麻醉药品的种类、用量、金额、DDDs等进行归类统计、比较和分析。结果:统计结果表明,本院住院部使用麻醉药品的用量及金额呈上升趋势。临床应用以芬太尼类居首。新型麻醉药品的应用也有上升趋势。结论:本院住院部麻醉药品应用基本合理,但仍存在一些不合理的习惯用法,需进一步提高合理用药水平。
Objective To analyze the impact of removing medicine makeups and two rounds of medical service price adjustment reform on inpatient expenses, and to provide reference for policy-making and adjustment of hospital management strategy. Methods Select the front page data of medical records of the case hospital medical record management system from 2016 to 2018. According to the time of cancellation of drug addition and two rounds of medical service price adjustment reform, the data on the first page of medical records in the hospital medical record management system are divided into two groups, including before the implementation of the policy (2016) and after the implementation of the policy (2017-2018). Interrupted time series (ITS) was used to analyze the changes of hospitalization expenses before and after the adjustment of the policy. Results Before the implementation of the policy, the average hospitalization expenses in 2016 was (17 863.35±334.73) yuan; After the implementation of the policy, the average hospitalization expenses in 2017 was (18 066.16±398.42) yuan, and the average hospitalization expenses in 2018 was (18 238.95±258.28) yuan. ITS analysis showed that before the implementation of the policy, the average hospitalization expenses of patients increased by 26.616 yuan per month, but there was no statistical significance (P=0.323). In the month when the policy was implemented (December 2016), the average hospitalization expenses of patients decreased by 141.212 yuan, but there was no statistical significance (P=0.547). After the implementation of the policy, the slope of average hospitalization expenses of patients 22.363, and the inpatient expenses showed an upward trend, but there was no statistical significance (P=0.881). In the past three years, the drug expenses has decreased by 13.64%, the material expenses has decreased by 3.69%, and the labor expenses has increased by 12.25%. Conclusions After the removing medicine makeups and two rounds of medical service price adjustment reform, the drug expenses and material expenses decreased during hospitalization, and the labor expenses increased, but no change in hospitalization expenses.
ObjectiveTo compare and analyze the expenses of inpatients before and after the implementation of the adjustment plan for " abolition of the addition of drug expenses” (also called zero-addition of drug costs) in Sichuan Province, in order to provide a certain reference for understanding the effect of this reform policy and further optimizing the formulation.MethodsFrom the hospital information management system, the data of inpatients with gastric cancer in a tertiary general hospital in Sichuan Province from January to September 2016 (before implementation) and from January to September 2017 (after implementation) were collected and compared. The change in hospitalization expenses of relevant patients before and after the implementation of the adjustment plan for canceling the addition of drug expenses was analyzed.ResultsA total of 2 878 patients were included in the survey; from January to September 2016,1 453 patients were included, and from January to September 2017, 1 425 patients were included. Before and after the implementation of the policy, the median hospitalization expenses of patients with gastric cancer decreased from 7 331.31 yuan to 7 145.12 yuan, with a decrease of 2.54%; the median expenses of medicines decreased from 4 839.79yuan to 4 246.10 yuan, with an decrease of 12.27%; the median expenses of check and inspections increased from 740.00 yuan to 859.00 yuan, with an increase of 16.08%; the median expenses of treatment increased from 251.00 yuan to 424.00 yuan, with an increase of 68.92%; compared with the total expenses and drug expenses before implementation, the total expenses and drug expenses after implementation decreased significantly, while material expenses, treatment expenses, check and inspection expenses and other expenses increased somewhat (P<0.05); differences in radiotherapy expenses and surgical treatment expenses before and after the implementation of the policy were not statistically significant (P>0.05).ConclusionsAfter the implementation of the policy of " abolition of drug expenses addiction”, the total expenses is slightly reduced for the expenses composition of patients with gastric cancer. Through the strengthening of the internal operation and management of the hospital, the government should continually optimize the public medical institution. At the same time, the government should put the compensation mechanism in place and continuously improve the payment method of medical insurance to ensure that the medical value of medical personnel is respected and the medical needs of ordinary people are guaranteed.
Objective This study aims to conduct a multi-dimensional quantitative evaluation of three rapid-acting insulin analogues, aspart (Novolog), lispro (Humalog), and glulisine (Apidra) to provide references for the selection of these drugs in medical institutions. Methods The recommended methods from the "Quick guideline for drug evaluation and selection in Chinese medical institutions (the second edition)" were employed to evaluate the pharmaceutical characteristics, effectiveness, safety, cost-effectiveness, and other attributes of the three rapid-acting insulin analogues. Results The total scores of insulins aspart (Novolog), lispro (Humalog), and glulisine (Apidra) were 73.5, 80.4, and 70.9, respectively. Insulin lispro (Humalog) had the highest score, demonstrating a prominent advantage in both effectiveness and cost-effectiveness dimensions. Conversely, insulin glulisine (Apidra) had the lowest score, with ratings in effectiveness and safety dimensions lower than those of the other two rapid-acting insulin analogs. Conclusion When selecting rapid-acting insulin analogs, healthcare institutions can choose one or more insulins, aspart (Novolog), lispro (Humalog), or glulisine (Apidra), all of which are strongly recommended, with priority given to insulin lispro (Humalog), which has the highest total score.
近十年，在药品不良反应监测领域，基于医疗保健数据库的安全信号检测方法受到越来越多的关注，已成为弥补自发报告固有局限性的重要手段。目前数据挖掘方法主要基于比值失衡分析法（disproportionality analysis）、传统药物流行病学设计（如自身对照设计）、序列对称分析（sequence symmetry analysis，SSA）、序贯统计检验（sequential statistical testing）、时序关联规则（temporal association rules）、监督机器学习（supervised machine learning，SML）、树状扫描统计量方法（tree-based scan statistic）等。本文从应用场景和实用性角度对医疗保健数据库中安全信号检测方法及其性能进行介绍。
目的:探讨药品差错发生后,药剂科的应对和处理预案,找出克服和避免的有效办法。方法:分析药剂科医疗差错或医疗事故发生的主要类型。 结果:提出不同类型差错发生后的防范和应对措施。结论:积极合理的防范和应对药品差错事件,对改善医患关系及提高有效治疗有重要意义。