藥師介入對醫院用藥品質初期分析：某醫學中心「異常處方」執行效益

Benchmark Analysis of Pharmacy Intervention on Quality of Hospital Prescribing

許茜甯(Chien-Ning Hsu) ； 郭虹君(Hung-Chun Kuo) ； 戴慶玲(Ching-Ling Tai)

《醫療品質》 2卷2期 (2002/04) Pp. 15-24

摘要

本文主要是探討醫院藥師主動介入醫師處方對病患用藥品質及保險給付效益影響。南部某醫學中心藥師介入部分住院及門診處方，並經原開方醫師同意更改的異常處方，由內部二至三位資深藥師確認異常處方更改的適當性及必要性後方納入分析。自民國九十年一月至六月由25位藥師提出的異常處方，納入分析件數共計2,550件，其處方型態包括處方疏失、用藥合理性、交互作用分別各佔總分析件數的59.4％、34.8％、2.2％。比照「全民健康保險醫事服務機構醫療服務審查辦法」中不支付標準，估計這些異常處方可能遭保險核刪的比例佔總分析件數的66.1％。依此分析結果，我們認為藥師介入有助於用藥品質保障，而保險給付效益部分更有其潛在貢獻度。

關鍵字

藥師介入 ； 用藥品質 ； 藥品調劑作業

並列摘要

This study is aimed to evaluate the contribution of pharmacy intervention on quality of hospital prescribing in the medical center. The study was conducted at one of hospitals in southern of Taiwan, a 2,389-bed medical center, included acute care unit, children and adult departments. The study site was limited to adult patients, except Pediatric, Psychiatric and OB-GYN units. We collected interventions 6months, from January 1, 2001 to June 31, 2001 by all 25 pharmacists to prescriptions for both inpatients and outpatients when they perceived inadequacies of drug prescriptions. Recording, of every intervention accepted by prescribing doctors. The appropriateness and quality of each pharmacists' intervention selected was evaluated by 2-3 independent senior pharmacists. Interventions (2,550 instances) was analyzed, of which 59.4% -associated with prescribing error、34.8% associated with improper drug use and 2.2% associated drug interaction. These interventions for approximately 66.1 % (1,685 instances) associated with cost saving. The descriptive analysis of pharmacy intervention showed the potential to minimize the contracted rate of principles on drug reimbursement insurance, and to improve quality related drug therapy.

並列關鍵字

Pharmacy interventions ； Medication quality ； Dispensing