摘要
目的探讨疾病诊断相关分组(DRG)支付模式下临床路径优化前后胆囊结石并急性胆囊炎住院患者的用药合理性和经济性。方法根据DRG分组原则,选取医院肝胆胰外科2020年10月至12月(临床路径优化前,38例)和2021年10月至12月(临床路径优化后,42例)收治的行腹腔镜下胆囊切除术的胆囊结石合并急性胆囊炎患者,分别作为对照组和观察组。基于对照组患者的用药信息整理后提出合理用药建议,形成临床路径,再提取相同路径患者进行用药分析,比较两组患者用药合理性和经济性。结果合理性方面,观察组患者质子泵抑制剂、止血药使用率均显著低于对照组(P<0.05)。经济性方面,观察组患者抗菌药、镇痛药、保肝药例均费用,药品费用、总费用及占比均显著低于对照组,住院时间显著短于对照组(P<0.05)。结论基于DRG支付模式,优化临床路径可进一步规范胆囊结石并急性胆囊炎患者的用药合理性,提高用药经济性。
Objective To investigate the rationality and economic evaluation of inpatients with gallstones combined with acute cholecystitis before and after the optimization of clinical pathway under disease diagnosis related group(DRG)payment mode.Methods Patients with gallstones combined with acute cholecystitis who underwent laparoscopic cholecystectomy in the Department of Hepatobiliary and Pancreatic Surgery of the hospital from October to December 2020(before the optimization of clinical pathway,38 cases)and from October to December 2021(after the optimization of clinical pathway,42 cases)were selected and divided into the observation group and the control group according to the DRG grouping principle.Based on the medication information of patients in the control group,the medication rationality suggestions were put forward to form the clinical pathway,and then the patients with the same pathway were extracted for medication analysis,the rationality and economy of medication in the two groups were compared.Results In terms of rationality,the usage rates of proton pump inhibitors and hemostatic drugs in the observation group were significantly lower than those in the control group(P<0.05).In terms of economy,the average cost percase of antibiotics,analgesics,and hepatoprotective drugs,the average drug cost,total cost and the drug expenditure ratio in the observation group were significantly lower than those in the control group,and the length of hospital stay in the observation group was significantly shorter than that in the control group(P<0.05).Conclusion Based on the DRG payment mode,optimizing the clinical pathway can further standardize the rationality of medication for patients with gallstone combined with acute cholecystitis,and improve the economy of medication.
作者
徐超然
杨玉洁
崔芬芳
徐敏
XU Chaoran;YANG Yujie;CUI Fenfang;XU Min(The Third People′s Hospital of Chengdu,Chengdu,Sichuan,China 610000)
出处
《中国药业》
2025年第16期35-39,共5页
China Pharmaceuticals
基金
四川省成都市医学科研课题项目[2023210]。
关键词
疾病诊断相关分组
临床路径
合理用药
胆囊结石
急性胆囊炎
clinical pathway
disease diagnosis related grouping
rational drug use
gallstone
acute cholecystitis
