The Impact Of The Medical Insurance Drug Catalog And Review Rules On The Medical Burden Of Urban And Rural Residents

The List of Drugs for National Basic Medical Insurance,Industrial Injury Insurance and Maternity Insurance(2019 Edition)is a comprehensive adjustment to the original list,aiming to standardize rational clinical drug use and protect patients' rights and interests in drug use.For drugs directory update new adjustment and upgrade of drug use audit rules,for the use of clinical drug monitoring and analysis of medical institutions,the waste of medical resources,prevent effectively in order to guarantee the medical insurance fund expenditure,eventually to reduce urban and rural residents medical drug expenses burden,safeguard the rights and interests of the patient's medication.From the perspective of medical insurance fund,the catalog of medicines and update new adjustment and upgrade of drug use audit rules,for the use of clinical drug monitoring and analysis of medical institutions,the waste of medical resources,prevent effectively spending in order to guarantee the medical insurance fund,ultimately achieve alleviate urban and rural residents medical drug expenses burden,safeguard the rights and interests of the patient's medication.Basic the settlement data health care system of Yuxi Jiangchuan District People's Hospital,for example,to monitor and medicine "Cerebrolysin" and chronic disease outpatient drug "Metoprolol " and special disease drug " Haikun Shenxi Capsule " as the breakthrough point,to adjust the catalog of medicines and the corresponding outpatient chronic diseases,special diseases drugs "small directory" adjusted the running situation of the two data model design,track the actual medical insurance settlement of medical institutions nearly 12000 drug utilization data record,analysis shows that after adjust the catalog of medicines and monitored drugs,special disease outpatient service,chronic diseases,the running situation of clinical application.According to the statistical analysis of drug data,the adjustment of key monitored drugs in drug List is in line with the expected effect of national supervision,guiding clinical rational drug use and reducing the economic burden of non-essential drugs in the treatment of related diseases of urban and rural residents.The adjustment of medication scope in hypertension outpatient department failed to reflect the effect of eliminating " Metoprolol " on reducing drug burden on patients.Adjusting the payment restriction of "Haikun Shenxi capsule" has positive effect on the burden of medical expenses of outpatient treatment of patients with "chronic renal failure".Effectively reduce the "chronic renal failure" outpatient treatment medication is not necessary,avoid such patients unnecessary drug expenses.The establishment of drug audit rules has positive control effects on protecting patients' rights and reducing drug cost burden.To a certain extent,medical institutions pay attention to the rational and compliant use of drugs,guide medical institutions to rational drug use,effectively reduce the overall unreasonable use of drugs in the district people's hospital,and reduce the unnecessary drug expenditure of patients.