目的:通过建立合理用药三级监管体系,有效促进临床合理用药,控制药品费用增长,保障患者用药安全、有效、经济。方法:在某家大型公立医院,建立由合理用药软件提示、医院药师审核干预、专家点评、医院行政监管处罚四者有机结合共同组成的三级监管体系,对医院医嘱实施全程审核监管、即时干预。结果:2015年3月1日-5月1日共审核并修改2728条不合医嘱,药品总消耗与去年同期相比下降5.9%、住院人均药品费用与去年同期相比下降5.5%。结论:合理用药三级监管体系有效监管了临床用药行为,保障了患者的用药安全,同时有效控制了医院药品费用的增长趋势。

OBJECTIVE To build up a three-stage supervision system to effectively promote rational use of drugs and ensure patient medication safety, to help to control expenditure of drug cost.METHODS In some large public hospitals, a three-stage supervision system of rational drug use consists of rational drug software, hospital pharmacists, prescription comments and administrative supervision, which helps for full course review, supervision and instant intervention for implementation of medical orders.RESULTS The system refused 2728 medical orders from March 1st to May 1st, 2015. Total drug consumption decreased by 5.9% and per capita drug cost fell by 5.5% compared to that in the same period of last year.CONCLUSION The three-stage supervision system is useful to protect patient medication safety and can effectively control growth of hospital drug costs.