全国人大代表葛明华:医药分家后药师更多的参与临床用药安全工作

2019-02-27 沙 琼 环球网

公立医院医改从一开始就强调推动“医药分家”,破除“以药养医”,让公立医院的药房回归公益性,随着改革的不断推进,大多数医院已经逐渐实现医药分家,那么,现在的医院、医生和药师角色有何变化呢?

公立医院医改从一开始就强调推动“医药分家”,破除“以药养医”,让公立医院的药房回归公益性,随着改革的不断推进,大多数医院已经逐渐实现医药分家,那么,现在的医院、医生和药师角色有何变化呢?

  全国人大代表、浙江省人民医院院长葛明华在全国“两会”代表委员谈健康的发布会上表示,目前我们医疗卫生行业在破除“以药养医”方面做得最好的事情就是药品零差率,医院进药与最后卖给患者的价格是没有差异的,医院没有任何营利。

  “浙江省卫健委从2014年4月1日起在全省推行药品零差率,浙江也是全国第一个全面实行药品零差率的省份。推行以后有几个好处:一是既往“以药养医”的理念彻底消除。二是在总体不增加患者实际医疗费用负担的同时,通过调整医疗服务价格,提高手术费、治疗费、护理费、诊查费,使医疗收入结构得到良好调整,医务人员收入得到提高。通过这样的调整,医务人员的积极性增加了,医院医疗服务能力和服务水平也提高了。”

  既往医院药师更大的功能是发药,现在通过角色转变,已经有很大的变化,药师更多的是参与临床工作。怎么参与呢?

  葛明华介绍,“以浙江省人民医院为例,药师与临床医生一起参与患者的药物治疗方案,主要从三方面开展,一是事前的医嘱干预,二是事中的医嘱审核,三是事后的医嘱监管。事前的医嘱干预主要是通过药师参与合理用药软件的开发,在临床医生开出医嘱的时候,通过药师的设定,软件进行自动检测,如果这是一个明显违背规范的方案,软件就进行自动拦截。事中审核是指临床医生开出方子,药师在线上进行审核,有一些小的问题软件识别不了,药师就在线上通过人机结合模式进行审核。事后监管主要是通过处方点评,分析发现的问题,并针对问题对用药软件等一系列工作进一步完善。”  

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    2019-03-01 cathymary

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