【摘要】 目的:研究不同付费方式对脑梗死住院患者用药的影响。方法:回顾性调查2006年脑梗死住院患者用药情况,选出用量最大的10种注射剂。将患者分成公费、医保和自费3组,分析临床转归、次均药费、次均住院费、10种注射剂的用药频次和次均用量的差异。结果:①调查病例1 208份,其中公费169例、医保734例、自费305例;②3组患者临床转归可比情况下,公费次均药费、次均住院费分别高于医保和自费20.45%、22.86%和26. 69%、38%;③:医保报销目录内品种的用药频次和次均用量,公费>医保>自费;目录外品种自费>公费>医保;3组差异主要体现在3个用量大的品种(桂哌齐特、舒血宁、依达拉奉)和1个价格最高的品种(前列地尔)。结论:不同付费方式对脑梗死住院患者用药有影响,公费医疗管理亟待改进,医保药品报销目录有待进一步完善。更多还原

【Abstract】 Objective:To study the effect of different payment manners on the drug use in inpatients with cerebral infarction.Method:The drugs used for discharged inpatients with cerebral infarction were retrospectively studied in 2006. The top 10 frequently used injections were then selected.According to different payment manners,all the inpatients were divided into three groups,i.e.government employee insurance group,medical insurance group and uninsured group.Then the outcomes,average cost of drug and hospitalization,frequency and average amount of the 10 injections among three groups were analyzed.Result:①1208 patients were investigated,including 169 from the government employee insurance group,734 from the medical insurance group,and 305 from the uninsured group;②Under the comparable condition,the average costs of drugs and hospitalization of the government employee insurance group were respectively 20.45%,22.86% and 22.86%,38%higher than those of the medical insurance group and uninsured group;③The comparison of drug use frequency and average amount was as follows:in the drugs covered in the medical insurance directory,the government employee insurance group’s were higher than the medical insurance group’s that were higher than the uninsured group’s while in the drugs not covered in the medical insurance directory,uninsured group’s were higher than the government employee insurance group’s that were higher than the medical insurance group’s.The differences were markedly higher in the three highest dosage drugs,i.e.cinepazide,shuxuening,edaravone and alprostadil,a most expensive drug,i.e.Conclusion:The different payment manners affect the drug use for patients with cerebral infarction;the government employee insurance should be regulated more strictly;in addition,the medical insurance directory needs further refining.更多还原