王笛 王相峰 毛丽超 熊伟 赵靖

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2021）08-0911-04

DOI 10.6039/j.issn.1001-0408.2021.08.03

摘 要 目的 ：探讨重点监控药品监测平台的合理应用管理指标，为提高重点监控药品临床应用管理水平提供参考。方法：采用文献研究和专家论证的方法，提出医疗机构重点监控药品的指标。结果与结论：最终明确了医疗机构采购前20位药品目录、重点监控药品采购品规数、住院患者重点监控药品使用率、重点监控药品收入占比、住院患者重点监控药品费用增幅、住院患者单个重点监控药品费用增幅、住院患者重点监控药品次均费用增幅、使用重点监控药品的医嘱点评比例等8项重点监控药品通用性指标，以及医疗机构基本情况、病案首页、住院患者用药数据、医疗机构药品采购数据等4项数据采集项目。综上，建立的医疗机构重点监控药品监测平台可为提高重点监控药品临床应用管理提供参考。

关键词 重点监控药品;监测平台;数据采集;合理用药

Discussion on the Monitoring Platform of Rational Use Management Indexes of Key Monitored Drugs of Medical Institutions in China

WANG Di1，WANG Xiangfeng2，MAO Lichao2，XIONG Wei3，ZHAO Jing1（1. National Center for Medical Service Administration， National Health Commission of the Peoples Republic of China， Beijing 100810， China; 2. Dept. of Pharmacy， the First Hospital of Jilin University， Changchun 130031， China; 3. Dept. of Clinical Engineering and Information Technology， the First Affiliated Hospital， College of Medicine， Zhejiang University， Hangzhou 310003， China）

ABSTRACT   OBJECTIVE： To discuss the monitoring platform of rational use management indexes of key monitored drugs， and to provide reference for improving their clinical application management. METHODS： The method of literature research and expert demonstration was adopted， the indexes of key monitored drugs in medical institutions were put forward. RESULTS & CONCLUSIONS： Finally， Eight general indexes as the list of top 20 drugs purchased by medical institutions， the specifications of key monitored drugs purchased， the utilization rate of key monitored drugs of inpatient， the proportion of key monitored drugs revenue， the increase in the cost of key monitored drugs of inpatient， the increase in the cost of key monitored drug of single inpatient， the increase of the cost per time of key monitored drugs of inpatient， the proportion of doctors order review for key monitored drugs were defined. Four major data acquisition projects as the general information of medical institutions， medical record homepage， inpatient medication data， and medical institution drug procurement data were also defined. The monitoring platform of key monitored drugs in medical institutions can provide reference for improving the management of clinical application of key monitored drugs.

KEYWORDS   Key monitored drugs; Monitoring platform; Data acquisition; Rational drug use

近年來，随着我国医疗卫生体制改革的深化，如何应对医保控费、取消药品加成等措施对医疗机构管理的影响，如何加强合理用药的管理、减轻患者的经济负担，已经成为大众关注的问题。其中，重点监控药品滥用的现象受到各方关注和重视，已逐渐成为合理用药管理中的重点监管对象之一[1-2]，保证重点监控药品的合理应用是各医疗机构的重要工作内容。

2018年12月，国家卫生健康委医政医管局发布《关于做好辅助用药临床应用管理有关工作的通知》，指出要加强医疗机构辅助用药临床应用管理、规范辅助用药临床应用行为、提高合理用药水平、维护人民群众健康权益，并就做好辅助用药临床应用管理有关工作提出了具体要求[3]。……