Design And Implementation Of The Pass-based Rational Drug Use Review System

As the State Medicine Catalogue for Basic Medical Insurance has been formulated and continuously improved, and the supervision of drug-use in hospital has been strengthened, the phenomenon of irrational drug use is gradually reduced. According to the latest statistics, however, more than 630,000 case reports for adverse drug reaction were sent to National Adverse Drug Reaction Monitoring Center in 2009, which shows more efforts should be made in rational drug-use.Considering the domestic actual situation, based on the objectives of safe and rational medication, this thesis sought to highlight the economic targets. After analyzing and comparing the evaluation methodology for pharmacoeconomics, this thesis used Cost-Effectiveness analysis in patient regimen. Extraction, transformation and loading were operated in these regimen, thus data warehouse was built. Based on the data warehouse, data mining and on-line analytical processing were carried out; finally the decision support was realized.In this thesis, the patient regimen was from the data of a top three hospital in the recent three years, including diagnosis, condition changes, orders, costs etc. Then this regimen was classified by age, diseases and other theme. Nearly 9 million options were screened and analyzed by Cost-Effectiveness Method. It was found that the percentage of drug costs in patient's medical costs declined but still high. In the current background that medical economic developed rapidly but doctor-patient conflicts was fairly prominent, achieving the economic objective of rational drug use is of important value to society, hospital and individuals. At the same time, our country has concentrated monitoring efforts in rational drug use and implemented the medical separation reform. How to realize rational drug use in hospital has been the current urgent problems. Our research results can provide support in this aspect also.Following the ETL process, a data warehouse was built, which could provide the data base to the expert system in rational drug use. Then a centralized storage system, which was quite different from the OLTP system, was built. The data warehouse contained a lot of business data that extracted from hospital database and vividly reflected the reality in hospital. It could help hospital develop better to analyze the historical data accurately and effectively. The application of data warehouse technology played an exemplary role in HIS.The expert system in rational drug use in this thesis belongs to the decision support system, which will expand its evaluation scope and content and provide more comprehensive decision support in hospital management. For example, in the expert system, not only the medical quality was improved, but also the health-care cost was reduced, which could push the benign development of hospital.