我院2009-2011年门诊退药情况分析及干预建议

摘要

目的：通过对我院门诊退药情况的调研和分析，探索并提出干预和降低我院退药发生的建议，促进临床合理用药。方法：从我院药房信息系统（pharmacy information system, PIS）调取2009年1月1日–2011年12月31日的门诊退药数据，对退药的品种、金额、科室、频率等数据进行统计，分析造成退药的主要原因和影响因素。结果：我院2009–2011年门诊退药总次数、总金额均呈上升趋势；三年中，退药次数与退药金额位于前十位的科室及退药类别相对集中；应关注单价较高的品种退药金额的增长，除诊断用药外，退药金额的变化趋势与退药次数没有相关性；退药原因主要包括医生开错、患者自愿不取、医保过量等因素。结论：退药现象客观存在，医院需从信息系统、处方行为、医保筛查和管理制度等方面构建完整的退药干预系统，借助PDCA理论持续改进，减少退药的发生。%　　Objective:To investigate the situation of drug repercussion in outpatient, explore and put forward suggestions to reduce the occurrence of drug repercussion in outpatient for promoting clinical rational drug use. Methods:The data about outpatient drug repercussion were collected from the Pharmacy Information System (PIS) of our hospital between January 1, 2009 and December 31, 2011, and analyzed in respect of types of returned drugs, the amount of money, the department, and the frequency. The main reasons and influencing factors of drug repercussion were analyzed. Results:Of the three-year data, the occurrences of outpatient drug repercussion and the total amount of the money were on the rise. The top 10 departments in terms of the frequency and amount of money of drug repercussion and the categories of drug repercussion relatively concentrated. We should concentrate on the amount growth of drug repercussion in expensive drugs. In addition to the diagnostic medicine, no correlation between amount of money and frequency during the occurrence of outpatient drug repercussion was observed. The causes of drug repercussion included doctors' mistakes, patients' voluntarily renouncing, excess health insurance and so on. Conclusion: Drug repercussion phenomenon exists objectively in hospital, and a complete drug repercussion intervention system should be built in information system, prescription behavior, medical insurance checking and management system. We should reduce the occurrence of drug repercussion with continuous improvement by the use of PDCA theory.