芦山地震后1月内四川大学华西医院应急药品使用费用分析
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摘要
目的基于芦山地震伤病员疾病谱的实际药品使用情况,分析四川大学华西医院芦山地震后1月内应急药品使用费用。方法收集该院震后1月内以应急药品的日使用金额、各药理分类占所有品种的累计百分率、日均费用、人均费用、DUI等于1时日均费用、人均费用、日均差额和人均差额等资料,使用Excel软件录入数据,统计分析芦山地震后1月内伤员应急救治药品的使用费用。结果芦山地震后1月,该院收治伤病员人数与药品使用金额波动趋势一致,提示费用趋势合理。ICD-10标化的伤情分类为6类,12种伤,药物使用费用占总费用比例为71%。病情分6类,药物使用费用占总费用比例为21%。基于伤情的药物共3类18种,人均费用和日均费用均值分别为1 702.70元和186.87元。基于病情的药物共5类28种,人均费用和日均费用均值分别为185.13元和38.96元。注射给药人均费用和日均费用均值分别为口服给药方式的14.52倍和5.08倍。进口药物人均费用和日均费用均值分别为国产药品的7.10倍和5.28倍。结论影响药物使用费用的因素有:①伤病员的疾病负担和病情;②给药方式(注射剂vs.非注射);③同类药物是国产或进口;④DUI值评价的用药合理性。DUI>1,静脉给药及进口药物占比大,均可增加地震伤病员的用药费用。"应急救援药品服务包"备药应以伤情为主、病情为辅。为保证用药的及时、安全和有效,以注射剂为主,但其包装应能防摔防震,方便使用,剂量合理、满足病情需要。
Objective To analyze the costs of emergency medication in the West China Hospital within one month ater Lushan earthquake based on actual medication of the victims' disease spectrum. Methods We collected emergency medication data as evaluation index in the West China Hospital within one month ater Lushan earthquake, including daily cost, cumulative percentage of pharmacology category, average cost per day/person, average cost per day/person when DUI=1, difference between average cost per day /person, and average cost per day/person when DUI=1, etc. hen,we input data using Excel software for statistically analyzing the costs of emergency medication within one month ater the earthquake. Results During one month ater the earthquake, the costs changed consistently with the number of victims, which implied the change of costs was rational. Injuries were classiied into 6 categories and 12 kinds according to ICD-10. he costs of medication accounted for 71% of the total costs. Six kinds of illness accounted for 21%. Medication for injuries was classiied into 3 categories and 18 kinds; average cost per day was 186.87 yuan and average cost per person was 1 702.70 yuan. Medication for illness was classiied into 5 categories and 28 kinds; average cost per day was 38.96 yuan and average cost per person was 185.13 yuan. he mean value of average cost per day/person of injection was 14.52/5.08times more than that of non-injection. Meanwhile, the mean value of average cost per day/person of imported medication was 7.10/5.28 times more than that of domestic medication. Conclusion he factors that impact the medication costs include: a) disease burden and traumatic conditions of the sick and wound; b) administration pathway(injection vs. noninjection); c) imported or domestic medication; and d) the rationality of taking DUI as evaluation index. When DUI>1,injection through the vein and imported medication take a larger share which increase the costs of medication. Emergency rescue package should mainly prepare for the injury. In order to ensure the timely, safe and efective medication, injection should be given priority to. We also should take into consideration crash-resistance/anti-quake package, reasonable dosage, convenience-to-use of drugs as well as the needs of the illness.
Objective To analyze the costs of emergency medication in the West China Hospital within one month ater Lushan earthquake based on actual medication of the victims' disease spectrum. Methods We collected emergency medication data as evaluation index in the West China Hospital within one month ater Lushan earthquake, including daily cost, cumulative percentage of pharmacology category, average cost per day/person, average cost per day/person when DUI=1, difference between average cost per day /person, and average cost per day/person when DUI=1, etc. hen,we input data using Excel software for statistically analyzing the costs of emergency medication within one month ater the earthquake. Results During one month ater the earthquake, the costs changed consistently with the number of victims, which implied the change of costs was rational. Injuries were classiied into 6 categories and 12 kinds according to ICD-10. he costs of medication accounted for 71% of the total costs. Six kinds of illness accounted for 21%. Medication for injuries was classiied into 3 categories and 18 kinds; average cost per day was 186.87 yuan and average cost per person was 1 702.70 yuan. Medication for illness was classiied into 5 categories and 28 kinds; average cost per day was 38.96 yuan and average cost per person was 185.13 yuan. he mean value of average cost per day/person of injection was 14.52/5.08times more than that of non-injection. Meanwhile, the mean value of average cost per day/person of imported medication was 7.10/5.28 times more than that of domestic medication. Conclusion he factors that impact the medication costs include: a) disease burden and traumatic conditions of the sick and wound; b) administration pathway(injection vs. noninjection); c) imported or domestic medication; and d) the rationality of taking DUI as evaluation index. When DUI>1,injection through the vein and imported medication take a larger share which increase the costs of medication. Emergency rescue package should mainly prepare for the injury. In order to ensure the timely, safe and efective medication, injection should be given priority to. We also should take into consideration crash-resistance/anti-quake package, reasonable dosage, convenience-to-use of drugs as well as the needs of the illness.
引文
1 金朝辉,徐珽,李幼平,等.芦山地震后1月内四川大学华西医院收治伤病员应急药品使用合理性研究.中国循证医学杂志,2013,9():.
2 鲲鹏,陈埙吹,陈曼莉,等.“汶川地震”灾后医疗救助(治)服务包设计实证研究.中国卫生经济,2010,29(11):33-35.
3 陈竺,沈骥,康均行,等.特大地震应急医学救援:来自汶川的经验.中国循证医学杂志,2012,12(4):383-392.
4 陈曼莉,孙菊,陈瑶,等.泣川地震灾后医疗救助制度实施评价与建议.中国卫生经济,2011,30(1):50-52.
5 姜洁,李幼平,王觅也,等.玉树与汶川地震医疗救援比较研究.中国循证医学杂志,2010,10(5):550-554.
2 鲲鹏,陈埙吹,陈曼莉,等.“汶川地震”灾后医疗救助(治)服务包设计实证研究.中国卫生经济,2010,29(11):33-35.
3 陈竺,沈骥,康均行,等.特大地震应急医学救援:来自汶川的经验.中国循证医学杂志,2012,12(4):383-392.
4 陈曼莉,孙菊,陈瑶,等.泣川地震灾后医疗救助制度实施评价与建议.中国卫生经济,2011,30(1):50-52.
5 姜洁,李幼平,王觅也,等.玉树与汶川地震医疗救援比较研究.中国循证医学杂志,2010,10(5):550-554.
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