背景:近年来,世界卫生系统面临着成本不断增长的趋势。在这方面,医院是消耗卫生系统总支出很大一部分的环境之一。药物是医院中最昂贵的组成部分之一,这需要适当的测量来控制和降低成本。本系统综述旨在确定医院成本控制的策略和措施。
方法:使用PRISMA协议,我们对这些文本进行了系统回顾,以确定降低药物成本的策略和措施.在这次系统审查中,在以下数据库中搜索了所选的关键词:科学网,Scopus,PubMed,谷歌学者,和Embase。入选标准包括英文文章,医院层面的研究,以及那些关于降低和控制医院成本的研究。排除标准还包括以下内容:初级卫生保健研究,非英语语言研究,卫生系统研究,研究只关注特定药物的成本效益。使用本研究中调整和修改的清单对这些文章的质量进行了调查。
结果:从审查的数据库中确定了总共4696篇文章,从其他一些来源确定了26篇文章。删除重复的研究并审阅标题后,summary,以及使用参考检查和补充搜索的文章全文,最后有21篇文章。从最后的文章中提取了许多策略或管理行动。根据定性结果,使用定性元合成,并在消除重复的解决方案后,数据分为五组:采购,storage,分布,处方,和使用。
结论:根据不断增加的药品成本,一些医院管理者现在尝试使用药品链管理来降低医院成本。药品成本降低策略可以应用于药品链管理的任何组成部分,如采购、storage,分布,处方,和使用。此外,这些策略的正确实施和药物使用的合理化将提高医院的效率。
BACKGROUND: In recent years, the world\'s health system faces with increasing trend of costs. In this regard, Hospital is one of the environments that consumes a large share of the total expenditure of the health system. Medications are one of the most expensive components in hospitals, which require appropriate measurements to control and reduce costs. The present systematic
review was conducted to identify strategies and actions for cost containment in hospital.
METHODS: Using the PRISMA protocol, a systematic
review of the texts was performed to identify strategies and actions for reducing drug cost. In this systematic
review, the selected keywords were searched in the following databases: web of sciences, Scopus, PubMed, Google Scholar, and Embase. The inclusion criteria included English-language articles, hospital-level studies, and those studies performed on reducing and controlling hospital costs. The exclusion criteria also included the followings: primary health care studies, non-English language studies, health system studies, and studies solely focussed on the cost-effectiveness of a particular drug. The quality of these articles was investigated using the checklist adapted and modified in the present study.
RESULTS: A total of 4696 articles were identified from the reviewed databases and 26 articles were identified from some other sources. After removing duplicate studies and reviewing the title, summary, and full text of articles using reference check and supplemental search, 21 articles were finally included. A number of strategies or managerial actions were extracted from the final articles. According to the qualitative results, qualitative meta-synthesis was used and after eliminating duplicate solutions, the data were classified into five groups: procurement, storage, distribution, prescription, and use.
CONCLUSIONS: According to the increasing cost of medicines, some hospital managers now attempt to reduce hospital costs using drug chain management. Drug cost reduction strategies can be applied for any component of drug chain management such as procurement, storage, distribution, prescription, and use. Also, proper implementation of these strategies and rationalisation of drug use will result in more efficiency of the hospital.