Analysis on the Refused Payment in Medical Insurance Drugs in One Hospital in 2016
10.3969/j.issn.1008-049X.2018.01.033
- VernacularTitle:2016年某院住院患者医保拒付药品费用分析
- Author:
Hui PENG
1
;
Fangjian WU
Author Information
1. 长江航运总医院· 武汉脑科医院药学科 武汉430010
- Keywords:
Refused payment in medical insurance drugs;
Rational drug use;
Excessive medication;
Off-label drug use
- From:
China Pharmacist
2018;21(1):128-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the refused payment in medical insurance drugs in our hospital in 2016 to promote the rational drug use.Methods:The refused payment in medical insurance drugs was analyzed , the reasons were summarized and the medication rationality was analyzed as well .Results:There were 372 cases of refused payment in medical insurance drugs in 2016 , and among them, 281 cases were with excessive medication accounting for 75.54％.There were 46 cases of off-label drug use, which accounted for 54.33％in the whole refused sum.The other reasons for the refused payment in medical insurance drugs included contraindication use of medication and violation of ladder medication etc .Conclusion:In the diagnosis and treatment process , doctors should be famil-iar with and follow the medical insurance payment system .The current health insurance payment system also requires a combination of medical technology , pharmacy economics and Chinese patient data .Medicare payment system needs to be improved by information technology.At the same time, pharmacists should play active role , and medical institutions should be encouraged to take effective measures to promote clinical rational drug use , which can promote the maximum normative treatment for each patient .
