摘要
目的:分析药学会诊对慢性肾脏病住院患者住院时间及经济负担的影响,探讨其临床效果与经济效应,为优化药师参与临床协作及合理用药政策提供依据。方法:回顾性分析2022—2024年该院慢性肾脏病住院患者资料,按年份及是否接受药学会诊分组(会诊组、非会诊组),采用Gamma回归、负二项回归模型,结合多组对照设计评估药师介入效果。结果:共纳入患者8404例。药学会诊率与住院时间、治疗费用呈负相关。年度分层结果显示,2022—2024年会诊组患者因高龄、合并症多、感染率高,住院时间延长,2022年会诊组患者费用较非会诊组增加5.2%;2024年推行驻科药师制度后,会诊率降至4.2%,但会诊组患者的住院时间较非会诊组缩短23.9%,重症患者管理效率提升。高龄、合并症多及感染显著增加医疗负担。结论:药师会诊通过优化用药方案缩短病程,但效果受病情严重程度和介入模式影响。驻科药师制度可通过日常化干预提升重症管理效率,建议结合前瞻性研究验证其长效效益,并推广标准化药学服务模式。
OBJECTIVE:To investigate the effects of pharmaceutical consultation on length of hospital stay and economical burdens of inpatients with chronic kidney diseases,probe into its clinical effect and economic effect,so as to provide references for optimizing pharmacists-participating clinical collaboration and rational medication policies.METHODS:A retrospective analysis was conducted on data from inpatients with chronic kidney diseases in the hospital from 2022 to 2024,patients were grouped by year and pharmacotherapy consultation(consultation group,nonconsultation group).Gamma regression and negative binomial regression model were adopted,in combination with multi-group control design,to evaluate the effects of pharmacist intervention.RESULTS:A total of 8404 patients were enrolled.Pharmaceutical consultation rates showed negative correlation with length of hospital stay and treatment cost.Annual stratification results indicated that patients in the consultation group from 2022 to 2024 had prolonged length of hospital stay due to advanced age,multiple comorbidities and higher infection rates,patients’costs in consultation group were increased by 5.2%compared with the non-consultation group in 2022.After the implementation of indepartment pharmacist system in 2024,the consultation rate decreased to 4.2%,while patients’length of hospital stay in consultation group were reduced by 23.9%compared with the non-consultation group,with improved management efficiency for critical patients.Advanced age,multiple comorbidities and infections significantly increased medical burdens.CONCLUSIONS:Pharmaceutical consultation shortens the disease course by optimizing medication regimens,yet the effectiveness varies with disease severity and intervention model.The in-department pharmaceutical system promotes management efficiency for critical patients through routine interventions,it is recommended to validate its long-term benefits through prospective studies,and promote standardized pharmaceutical service models.
作者
张本琦
梅茜
熊世娟
盛长城
张家兴
钱鑫
胡鳞方
陈琦
ZHANG Benqi;MEI Qian;XIONG Shijuan;SHENG Changcheng;ZHANG Jiaxing;QIAN Xin;HU Linfang;CHEN Qi(School of Pharmacy,Guizhou Medical University,Guiyang 550001,China;Dept.of Pharmacy,Guizhou Provincial People’s Hospital,Guiyang 550002,China)
出处
《中国医院用药评价与分析》
2025年第12期1441-1444,1448,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
国家卫生健康委医院管理研究所医院药学高质量发展研究项目(No.NIHAYS2415)。
关键词
药师会诊
住院时间
经济负担
慢性肾脏病
药学服务
Pharmaceutical consultation
Length of hospital stay
Economical burden
Chronic kidney disease
Pharmaceutical service
