门诊药占比分析

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,2021/10/10,*,门诊药占比分析,2021/10/10,1,01-09,月门诊药房销售金额前三十位药品,序号,药品名称,规格,单位,数量,金额,(元),DDDs,值,（排名）,1,恩替卡韦分散片,0.5mg*7s,片,35791,531479.10,35791（13）,2,阿托伐他汀钙胶囊,20mg*7s,粒,77217,457205.19,77217（5）,3,羟考酮缓释片,40mg*10s,片,12040,382149.60,12040（19）,4,坎地沙坦酯片,8mg*12s,片,189108,362396.92,189108,（,1）,5,非洛地平缓释片,5mg*10s,片,100370,313334.18,100370,（,3）,6,雷贝拉唑钠肠溶胶囊,20mg*14s,粒,48510,305905.00,48510,（,8）,7,硫酸氢氯吡格雷片,75mg*7s,片,34874,304281.18,34874,（,14）,8,阿托伐他汀钙片,10mg*7s,片,85428,301152.24,42714（11）,9,吉非替尼片,0.25g*10s,片,1230,290034.00,1230（25）,10,腹膜透析液,(乳酸盐),2000ml(1.5,),袋,10680,289855.20,11,泮托拉唑钠肠溶片,40mg*14s,片,72184,287699.36,72184,（,6）,12,甘草酸二铵肠溶胶囊,50mg*24s,片,281448,285727.27,31272（15）,13,吗替麦考酚酯胶囊,0.25g*40s,粒,20160,279377.28,2520(23),14,甲磺酸阿帕替尼片,0.25g*10s,片,1820,247344.12,1820(24),2021/10/10,2,15,狂犬免疫球蛋白,200IU,支,1386,246708.00,16,精蛋白重组人胰岛素混合注射液,(30/70),3ml:300IU(10.5mg),(,笔芯,),支,5681,244433.32,17,重组人促红素注射液,(CHO细胞),1ml:3000IU,支,8296,225485.28,18,苯磺酸氨氯地平片,5mg*14s,片,174440,222967.87,174440,(2),19,阿卡波糖胶囊,50mg*30s,粒,153180,217053.25,51060(7),20,雷贝拉唑钠肠溶片,20mg*10s,片,47580,203642.40,47580(9),21,格列齐特片（,II）,80mg*60s,片,185460,199833.15,92730（4）,22,人血白蛋白,5g,瓶,873,192060.00,23,银杏叶片,19.2mgx24s,片,122712,177830.14,40904（12）,24,脑心通胶囊,0.4x36s,粒,266184,174824.68,44364（10）,25,恩替卡韦分散片,0.5mg*7s,片,18844,169299.88,18844（18）,26,阿莫西林克拉维酸钾分散片,228.5mg(0.2g:28.5mg)*12s,片,104737,159374.82,26184（16）,27,吗替麦考酚酯分散片,0.25g*40s,片,22920,157575.00,22920（17）,28,门冬胰岛素,30注射液,3ml:300,单位,(笔芯),支,2257,156775.02,29,羟考酮缓释片,10mg*10s,片,18910,150901.80,4728（22）,30,尪痹胶囊,0.55g*60s,粒,138660,141104.45,9244（20）,合,计,7677809.70,2021/10/10,3,统计,2018,年,01,月,09,月我院门诊销售前三十位用药的用药金额和用药频度（,DDDs,）。限定日剂量参考新编药物学,17,版推荐的成人常用剂量，并结合药品说明书和临床实际应用情况综合确定。,DDDs=,某药品某时间段消耗总量,/,药品,DDD,值。对药品的金额和,DDDs,值进行排序。,DDDs,越大，说明药品使用频度越高。,由,上表,知，我院,2018,年,01-09,月,门诊,销售金额前三十位药品主要,集中,在抗肝炎病毒、,肿瘤靶向药、,高血脂、高血压、肝病辅助用药、高血糖、排异药、活血化瘀药、癌疼镇痛药及抗菌药物等慢性疾病几大类。我院,2018,年,01-09,月门诊前三十位药品销售金额,7677809.70,元，占我院,2018,年,01-09,月门诊所有药品销售金额的,48.06%,，接近,50%。,这个数据可以看出我院用药比较集中。,从,DDDs,值分析，我院门诊销售金额前三十位药品中口服制剂使用频率非常高，提示我院医院用药非常集中，坎地沙坦片、苯磺酸氨氯地平片、非洛地平缓释片、格列齐特片、阿托伐他汀胶囊、泮托拉唑肠溶片、阿卡波糖胶囊、雷贝拉唑钠肠溶胶囊、雷贝拉唑钠肠溶片、脑心通胶囊十个品种,DDDs,值排名前十名。,2021/10/10,4,表,一,:2018,年前三个季度按药品分类销售金额,药品,分类,国家谈判品种（元）,临时采购品种（元）,血液,制品（元）,狂犬疫苗及免疫球蛋白（元）,癌疼镇痛药缓释制剂（元）,常规采,购药品（元）,总合计（元）,化学药,630799.14,223750.36,193800,767124,574176.36,10550553.94,12940203.80,中成药,0,10212.45,0,0,0,3022186.57,3032399.02,合计,630799.14,233962.81,193800,767124,574176.36,13572740.51,15972602.82,占比,3.95%,1.46%,1.21%,4.80%,3.59%,84.99%,100%,2021/10/10,5,表,二,:2018,年,01-09,月份,门诊患者,每个月药占比,1月,2月,3月,4月,5月,6月,7月,8月,9月,药品费用（万元）,164.43,201.56,202.27,164.19,176.34,169.93,171.55,177.20,169.79,业务费用（万元）,416.47,492.66,554.42,404.35,492.02,491.63,445.00,430.39,415.74,药占比,39.48,40.91,36.48,40.61,35.84,34.56,38.55,41.17,40.84,2021/10/10,6,表,三,:2018,年前三个季度,门诊,药占比,1季度,2季度,3季度,前三季度,药品费用,5682588.30,5104603.48,5185411.0,15972602.82,业务费用,14635457.54,13880114.33,12911294.4,41426866.26,药占比,38.83,36.78,40.16,38.56,2021/10/10,7,表四：,2018,年前三个季度门诊各科室药占比情况表,科室,2018第1季度药占比（%）,2018第2季度药占比（%）,2018第3季度药占比（%）,2018前3季度,药占比（%）,院定药占比（,%）,备注,内一科,49.53,49.15,50.51,49.75,40,儿,科,38.66,34.46,29.22,35.14,33,产,科,26.28,20.35,19.92,21.4,16,外一科,22.19,28.12,29.09,26.48,27,不超,骨,科,16.16,17.48,14.77,16.10,21,不超,感染科,68.62,70.82,71.19,70.19,40,耳鼻喉科,52.33,52.12,52.49,52.31,23,眼科,54.08,56.31,55.97,55.52,18,皮肤科,73.88,68.41,73.75,71.83,60,口腔科,5.78,4.4,3.49,4.44,5,不超,2021/10/10,8,科室,2018第1季度药占比（%）,2018第2季度药占比（%）,2018第3季度药占比（%）,2018前3季度,药占比（%）,院定药占比（,%）,备注,急诊科,28.74,35.49,32.85,32.28,19,肿瘤科,90.14,89.82,86.98,88.92,42,内二科,47.65,47.6,44.85,46.72,40,神经外科,19.43,21.05,19.4,19.9,32,不超,血透室,16.40,16.98,15.55,16.29,14,ICU,39.10,24.72,43.65,33.79,27,康复科,34.87,30.14,31.36,32.32,15,外二科,24.48,24.38,23.09,23.98,27,不超,产科,27.53,26.41,21.23,26.25,16,内三科,47.33,48.23,51.04,48.74,40,便民门诊,67.43,67.82,72.20,69.07,40,专家门诊,46.79,44.16,49.6,47.15,40,合,计,38.83,36.78,40.16,38.56,30,超,2021/10/10,9,1、,统计范围：,2018,年,01-09,月份临床各科室门诊患者每个季度及前三个季度药占比。,2,、由表可以看出：,2018,年前三季度门诊患者的药占比为,38.56%,，与国家卫计委要求的,30%,差,8.56,个百分点。,3、,由表四知：,2018,年前三季度不超院定药占比的临床科室有：骨科、外一科、口腔科、神经外科、外二科，其余科室均超院定药占比。,2021/10/10,10,4,、由表二，可以看出：,2018,年前三季度我院全院门诊药品收入为,15972602.82,元，全院门诊业务收入,41426866.26,元，,2018,年前三季度门诊药占比,38.56%,。其中临时采购药品,消耗金额,为,233962.81,元，占门诊所有药品消耗金额的,1.46%，,国家谈判品种及国家医保谈判品种消耗金额为,630799.14,元，占门诊所有药品消耗金额的,3.95%，,癌疼镇痛药缓释制剂,消耗金额为,574176.36,元，占门诊所有药品消耗金额的,3.59%,。根据国家卫计委及省、市卫计委文件要求，国家谈判品种及国家医保谈判品种及,癌疼镇痛药缓释制剂,可不计入药占比，除去上述国家谈判品种及国家医保谈判品种及,癌疼镇痛药缓释制剂,消耗金额，我院门诊药占比为：,36.71%.,2021/10/10,11,5、,由表,二、三，,可以看出,：,我院,2018,年,01-09,月门诊每个月药占比均大于,35%,，,2,月份、,4,月份、,8,月份及,9,月份门诊药占比超过了,40%,，,2018,前三季度住院药占比与去年同期相比，有所下降。但我院的门诊药占比没有下降，与去年相比还有所上升，,2018,年前三季度住院药占比,为,30.65%,，,全院药占比,33.49%，,全院药占比与国家要求的药占比小于等于,30%,这个指标还是有很大距离，主要原因在于我院门诊,门诊药占比过高。,2021/10/10,12,讨论：门诊药占比过高的原因？,1、,随着人类社会经济的发展和相伴而来的不健康的生活方式的流行各种心、脑、肾慢性疾病及恶性肿瘤患者数目不断增长，导致慢性病患者用药需求的增加，也验证了前表，,我院,2018,年,01-09,月,门诊,销售金额前三十位药品主要,集中,在抗肝炎病毒、,肿瘤靶向药、,高血脂、高血压、肝病辅助用药、高血糖、排异药、活血化瘀药、癌疼镇痛药等慢性疾病几大类。,前三十位药品销售金额,7677809.70,元，占我院门诊所有药品销售金额的,48.06%,，接近,50%,。,2、,今年来，低价药涨价涨的太厉害，如硝酸甘油注射液以前一支需,0.78,元，现