243)门诊糖尿病患者临床药学服务的经济学评价.docVIP

门诊糖尿病患者临床药学服务的经济学评价初探龙恩武1 刘隽2 胡明2# 童荣生1# 1 四川省人民医院 成都 610072 2 四川大学华西药学院 成都 610041 摘要 目的：评价临床药师为门诊糖尿病患者提供健康教育服务的经济性,探索临床药学服务经济学评价方法。方法：自身干预前后对照试验。研究对象： 2010年5-6月纳入研究范围的41名糖尿病门诊初诊和复诊患者；临床药学干预措施：由临床药师给予健康教育；成本指标：测算临床药学服务时间成本和临床药师薪酬作为直接成本，临床药师培训成本作为间接成本。效果指标：采用用药依从性调查问卷，通过干预前调查和干预15天后电话随访调查评价用药干预前后用药依从性评分。结果：（1）临床药师提供健康教育前患者用药依从性得分为59.1，健康教育后为80.9，提高21.8%；（2）从医院支付角度，干预前医院临床药师服务成本为1480.76元，干预后成本为1887.57元；（3）临床药师为患者提供健康教育服务的成本/效果比为23.34,相对不提供服务的成本/效果比25.06，具有积极经济学意义。结论：（1）临床药学服务对改善用药结果有显著效果，（2）临床药师为门诊患者开展健康教育服务具有积极的经济效果，（3）开展临床药学服务经济学评价可为医疗机构药事服务费改革提供参考，（4）临床药学服务经济学评价方法还需完善。 关键词 临床药学服务 经济学评价 糖尿病门诊患者 健康教育 用药依从性 Exploratory Study on the economic evaluations of clinical pharmacy service for diabetic outpatients Long Enwu1, Liu Jun2, Hu Ming2#, Tong Rongsheng1# 1 Sichuan Provincial People s Hospital, Chengdu, 610072 2 West China School of Pharmacy, Sichuan University，Chengdu, 610041 ABSTRACT: OBJECTIVE To evaluating the economic outcome of health education service for diabetic outpatients provided by clinical pharmacist, and explore the method of economic evaluation of clinical pharmacy service in China. METHODS Self-control trial was adopted.41 diabetic outpatients who seek treatment in 6th,May to 7th june,2010 were involved in study. Patients were given health education by clinical pharmacist. Questionnaire survey was conducted by clinical pharmacist before and 15 days after intervention to obtain the score of compliance with medication as outcome indicator. Time of intervention, fee of clinical pharmacist training, salary of clinical pharmacist were estimated and recorded as the cost of clinical pharmacy intervention. RESULTS: (1)The score of compliance with medication of diabetic outpatients is 59.1 before health education, While it was rose to 80.9 15 days after health education;(2) on the view of hospital, the cost of pharmacy service without health education was 1480.76 yuan, and 1887.57 yuan with health education;(3)the C/E of pharmacy ser