·8· Chinese Hospitals,Feb.2020,Vol.24,No.2
特别策划
SPECIAL PLANNING
■ 卞 婧① 魏丽艳① 邵晓楠② 吴岢非② 甄健存①
张自忠小学①北京积水潭医院，100035 北京市西城区新街口东街31号②清华大学公共管理学院，100084 北京市海淀区双清路30号
【摘 要】目的：了解国内不同地区、不同级别医院的处方审核及点评工作开展情况，分析其影响因素，为进一步开展该项工作提供参考。方法：在全国范围内二级和三级医院中，通过电子调查问卷的形式，了解处方审核与点评工作开展情况。结果：样本医院中，处方前置审核、处方审核、处方点评的开展率分别为42.7%、84.6%、95.8%。特殊处方审核人资质高于一般处方，以多重用药处方最为明显。一般处方中，急诊处方、住院医嘱、门诊处方审核难度依次递减；静脉配置处方以及多重用药处方审核难度最大。处方审核及点评基本处于无偿状态。开展处方前审核仅8.6%的医院认为无压力，44.3%医院认为很有压力；压力主要原因在于缺乏电子审方系统及药师的规模和能力不足。结论：处方审核与点评是开展
率较高的药学服务项目，但前置审方的开展严重不足；具有政策引导和政策支持的地区及医院处方点评的开展率相对较好；通过培训、计算机辅助系统、区域点评等多种手段可提高药师处方审核及点评的能力；卫生行政部门、医院可通过补偿、绩效等手段促进处方审核和点评工作的开展。【关键词】处方前置审核 处方点评 审方人资质 补偿机制
中图分类号 R195 文献标识码 B DOI 10.19660/j.issn.1671-0592.2020.02.03
电冰箱保护器
Investigation and analysis of prescription review and evaluation in Chinese hospitals/ BIAN Jing, WEI Liyan, SHAO Xiaonan, WU Kefei, ZHEN Jiancun // Chinese Hospitals. -2020,24(2):8-11
【Abstract】Objective: In different regions and hospitals, the work of prescription review and evaluation was investigated. Analyzed the influencing factors of prescription review and evaluation. Provided reference for the next step of prescription review and evaluation. Methods: Electronic questionnaires were distributed in Grade II and Grade III hospitals nationwide. Statistics on the rate of prescription review and evaluation. To evaluate the qualification, time and difficulty of different types of prescription reviewers. Investigate the compensation mechanism of prescription evaluation and the pressure of prescription pre-review. Results: The rate of prescription pre-review, prescription review and prescription evaluation was 42.7%, 84.6% and 95.8% respectively. The qualification of sp
ecial prescription reviewers is higher than that of general prescriptions, especially for multi-drug prescriptions. The difficulty of review in general prescription is decreasing successively for emergency prescription, inpatient prescription and outpatient prescription. Iv and multidrug prescriptions are the most difficult. Prescription review and evaluation are basically free of charge. Only 8.6% of the hospitals considered that there was no pressure, and 44.3% considered that there was a lot of pressure. The main reason for the pressure is the lack of electronic prescription system and the scale and capacity of pharmacists. Conclusion: Prescription review and evaluation is a high development rate of pharmaceutical care, but the development rate of pre-review prescription is seriously insufficient. The development rate of prescription evaluations in regions and hospitals with policy guidance and support is relatively good. Through training, computer aided system, regional evaluation and other means to improve pharmacists prescription review and review ability. Health administration departments and hospitals can promote the development of prescription review and evaluation by means of compensation and performance.
江苏少儿频道【Key words】prescription pre-review, prescription evaluation, qualification of reviewers, compensation mechanism Author's address：
Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, PRC
军品论坛
随
着医药卫生体制改革的推进，卫生行政部门、医疗机构都越来越
关注合理用药。处方审核与点评能够在很大程度上促进合理用药[1]。全国各地区、各医疗机构均逐步开展处方审核与点评工作，但基本限于本医院或者本地区
中药制药[2-3]
。我国幅员辽阔，医疗
资源的不平衡、药师学历水平以及专业能力的差异，导致不同地区处方审核与点评工作开展情况不同。目前，尚未有针对全国不同地区、不同级别医院处方点评工作开展情况的调研。本研究分析我国东部、中部、西部的二、三级医院处方前置审核与点评的开展情况并分析其影响因素，对医疗
机构处方点评工作开展以及卫生行政部门对处方点评的支持提供参考。
1 资料与方法
1.1 调查对象
根据目前医疗机构中药学服务相关工作以及医疗机构设置与管理等问题设计调查问卷，利用某线上平台发放并回收问卷。在药学服务开展具有代表性和先进经验的地区中，选择若干所二级和三级医院发放问卷，由该医院药学部门的科室正、副职和业务骨干填写问卷。
将医院按地区分为中部、东部、
西部，按级别分为二级及三级医院，分别统计处方审核与点评的开展率。按处方审核与处方调剂的时间关系，将处方审核与点评工作分为处方前置审核、处方审核以及处方点评。处方前置审核，即医生
开具处方后经过审核方可缴费取药；处方审核即处方调剂过程中进行审核或调剂后对处方进行抽检及复核；处方点评为按一定规则和计划，由一定专业资历的专家定期或不定期对调配后处方进行点评。
1.2 研究方法
中央工艺美术学院回收问卷后，通过比对来自同一所医院的若干份问卷，并结合各医院、各地卫生健康委的公开数据，对426份电子问卷进行了筛选、清理和合并。
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