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目的:分析一家大型精神病医院在住院医疗费用从按项目付费变为按床日付费后临床用药行为的变化。方法:以医院的住院药品处方明细信息为基础,利用时间序列分析,比较支付制度变革前后,该医院在单位时间内医保病人药品使用量的变化。结果:每周药品使用量在支付制度变革以后明显下降,而“基本药物”的使用量则维持原有水平。结论:本案例中,支付制度的变革促使医院在保持医疗质量的情况下减少了“非基本药物”的使用。
OBJECTIVE: To analyze the changes of clinical medication behavior in a large-scale psychiatric hospital after the cost of inpatient medical services was changed from itemized payment to bed-based payment. Methods: Based on the hospital prescription information of prescription drugs, time series analysis was conducted to compare the change of drug usage of Medicare patients within the unit time before and after the payment system was changed. Results: Weekly drug use dropped significantly after the reform of the payment system, while the use of “essential drugs” remained at its original level. Conclusion: In this case, changes in the payment system prompted hospitals to reduce the use of “non-essential medicines ” while maintaining the quality of care.