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目的:掌握天津市城镇职工基本医疗保险住院患者药品使用状况及特点,为有效控制医保住院患者药品费用提供政策建议。方法:随机抽取2003—2007年天津市城镇职工参保住院患者10%的样本,用STATA软件对药品使用情况进行定量分析,从金额排名前100位和前10位药品的品种特征、剂型、数量和费用等方面对住院患者的药品使用情况进行深入分析。结果:2003—2007年,药品费用总额排名前100位的药品均占到当年药品费用总额的70%以上。2007年费用总额排名前100个药品中98个为注射用药,其中医保甲类药个数比例为61%,乙类药为39%。高额药品有在三级医院集中使用和少数大医院集中使用的趋势。结论:药品费用总额排名前100位的药品应该成为医疗保险药品费用控制的重点,注射剂滥用和乙类药使用比例过高可能是药品费用上涨的重要推动因素。应加强医保监督及合理控制注射剂和医保乙类药品的使用,重点关注三级医院药品的使用。
Objective: To master the status and characteristics of inpatients using basic medical insurance for urban workers in Tianjin and to provide policy recommendations for effectively controlling the cost of inpatients in medical insurance. Methods: A total of 10% of hospitalized patients in urban areas of Tianjin from 2003 to 2007 were randomly selected, and the use of STATA software was analyzed quantitatively. From the top 100 and the top 10 drugs, And costs and other aspects of inpatient drug use in-depth analysis. Results: From 2003 to 2007, the top 100 medicines and chemicals accounted for over 70% of the total cost of medicines in that year. In 2007, 98 of the top 100 drugs were used as injectable drugs, of which 61% were Medicines and 39% were Type B drugs. High-level medicines are used centrally in tertiary hospitals and concentrated in a few large hospitals. Conclusion: The top 100 drugs in total drug costs should be the focus of cost control of medical insurance. Injecting drug abuse and excessive use of B drugs may be the important driving factors for rising drug costs. Health insurance supervision should be strengthened and the use of injections and Medicare B drugs should be rationally controlled with a focus on the use of pharmaceuticals at tertiary hospitals.