Analysis of the Impact of Clinical Pharmaceutical Services on Rational Drug Use and Cost Control in Hepatobiliary Surgery Under the DRGs-based Payment Model
10.3870/j.issn.1004-0781.2025.07.022
- VernacularTitle:DRGs付费模式下临床药学服务对肝胆外科合理用药及成本管控的效果分析
- Author:
Xuanyu DUAN
1
;
Jin PENG
;
Yao DU
;
Xiaojie BIAN
;
Danying LI
;
Haixia ZHANG
;
Weihong GE
Author Information
1. 中国药科大学基础医学与临床药学学院南京鼓楼医院药学部,南京 210008
- Publication Type:Journal Article
- Keywords:
Clinical pharmaceutical services;
Rational drug use;
Diagnosis-related groups;
Hepatobiliary surgery;
Cost control;
Cost-benefit analysis
- From:
Herald of Medicine
2025;44(7):1150-1157
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of pharmaceutical services provided by clinical pharmacists on rational drug use and cost control in hepatobiliary surgery under the Diagnosis Related Groups(DRGs)payment model,aming to provide evidence for improving the rationality of drug therapy and saving medical costs.Methods Patients classified under DRGs disease codes HB15,HB13,and HB11 from November 2022 to April 2024 were selected as study subjects.A total of 195 patients were included,with 106 in the intervention group and 89 in the control group.The intervention group received multidimensional clinical pharmaceutical services in addition to the standard care provided to the control group.The rational drug use rate,medication costs,total hospitalization expenses,and length of hospital stay were observed between the two groups.A cost-benefit analysis was employed to evaluate the economic impact of providing pharmaceutical services to hepatobiliary surgical patients.The cost indicator was the clinical pharmacy services cost,and the benefit indicators were the reductions in total hospitalization expenses and medication costs.The benefit-cost ratio(B/C)was calculated,and sensitivity analysis was performed.Results The intervention group showed significantly higher rational use rates of prophylactic antimicrobial agents(drug selection:83.96％vs.46.07％,P＜0.01;treatment duration:84.91％vs.56.18％,P＜0.01)and parenteral nutrition drugs(97.17％vs.73.03％,P＜0.01)compared to the control group.Additionally,the intervention group had significantly reduced the length of hospital stay,total hospitalization expenses,medication costs,and insurance over-expenditure compared to the control group(P＜0.05).Furthermore,clinical pharmacist intervention led to a reduction in medication costs by 4 320.05(2 555.00,5 088.25)yuan(CNY)and total hospitalization expenses by 8 891.12(5 135.05,10 074.03)yuan(CNY).The B/C ratios were 14.24(8.42,16.77)and 29.30(16.92,33.20),respectively,indicating economic efficiency.Sensitivity analysis supported these results.Conclusion Under the DRGs payment model,clinical pharmaceutical services guided by drug therapy pathways contribute to improving rational drug use in hepatobiliary surgery and provide clear economic benefits,playing a positive role in reducing medical costs.
