2009~2012年我院门诊处方点评结果分析

The Prescription Evaluation and Analysis of Our Hospital’s Outpatient Service between 2009-2012

摘要: 目的：通过对我院2009~2012年为期四年的门诊处方点评结果的分析比较，以达到查找不足，持续改进，不断提升我院处方的规范化及合理用药水平的效果。方法：自2009年1月至2012年12月期间，每月随机抽取一天的门诊处方(不包含麻醉、精神类)，涵盖所有科室，四年共20,469张，对相关指标进行回顾性分析比较。结果：2009年1月至2012年12月，点评患者人数(年平均值)由274.2增加至326人，门诊就诊人数呈逐年递增。平均每位患者用药品种数(年平均值)在2.46~2.8之间浮动，符合WHO规定的发展中国家医疗机构门诊药品的合理使用标准：平均每张处方用药品种数为1.6~2.8种。平均每位患者处方金额(年平均值)由86.41元增长至184.13元，呈现逐年递增态势。抗菌药物使用率(%) (年平均值)由40.60%下降至22.18%，虽有明显降低，仍高于卫生部关于门诊患者抗菌药物处方比例不超过20%的规定。注射剂使用率(%) (年平均值)由27.21%下降至20.38%，略高于2006年WHO调查的发展中国家注射剂使用率的平均值19.0%。抗菌药物数量占药品总数的百分率(%)(年平均值)由17.70%下降至11.49%。不合理处方的发生率由15.86%下降至4.78%，处方规范化程度有了明显提高。结论：通过处方点评结合有效的行政干预，处方规范化程度及合理用药整体水平有了明显的改善提高。但处方点评的模式及范围尚有许多不足，需要进一步探索改进。

Abstract: Objective: The purpose of this observation/research is trying to find the weakness, make continuing im-provements and constantly upgrade our level of prescription standardization and reasonable drug use by analyzing and making comparisons on our hospital’s outpatient service in four years duration which is between 2009 and 2012. Ap-proach: From January 2009 to December 2012, we randomly select one day’s outpatient prescription (not include nar-cotic drugs and psychotropic drugs) covering all departments. There are 20,496 pieces in four years and then we apply the Retrospective analysis and comparison on related indexes and data. Results: The number of patients (in annually average) has increased from 274.2 to 326; outpatient clinic number had an increasing trend since January 2009 to De-cember 2012. The average number of varieties of drugs (in annually average) used on every individual patient is float-ing in the range between 2.46 to 2.8 which comply with the WHO’s requirements/standards on developing countries’ medical institutions for the legal usage of drugs in outpatient that is average number of each prescription allows drug varieties is between 1.6 to 2.8. The average spending on each prescription for a single patient (in annually average) has increased from 86.41 to 184.13 Yuan which shows an increasing trend year by year. Antimicrobial usage rate (in annu-ally average) fell to 22.18% from 40.60%, although it has decreased significantly, it’s still break the requirement that the proportion of outpatient antimicrobial prescriptions must be lower than 20% from the Department of Health. Injection usage (in annually average) has dropped to 20.38% from 27.21%, which is slightly higher than 19.0% which the aver-age usage of injection was assessed in 2006 in WHO’s survey in developing countries. The percentage number of total Antimicrobial and total number of drugs (in annually average) has decreased from 17.7% to 11.49%. Unreasonable prescription happening rate has decreased to 4.78% from 15.86%, and the level of standardization on prescription has been improved significantly. Conclusion: By prescription review combined with effective administrative intervention, prescription standardization degree and the reasonable drug use level had been improved. However, there are many de-ficiencies about prescription comment on mode and coverage needed to be enforced and improved in future.