中国临床药学杂志

目的 探讨肿瘤患者用药与疾病诊断相关分组（DRG）超支的相关性，为临床控制药品费用和提高合理用药水平提供依据。方法 以2022年1至12月某三级甲等医疗机构的RE1A病组患者为研究对象，采用单因素和多因素Logistic回归分析肿瘤患者用药与DRG超支的相关性。结果 共纳入1 729例患者，其中有431例患者出现DRG超支。多因素Logistic回归分析结果表明，中成药（OR=1.09,95%CI 1.04～1.14,P <0.001）、抗肿瘤药物（OR=1.07,95%CI 1.06～1.08,P <0.001）、血细胞刺激因子（OR=1.08,95%CI 1.05～1.10,P <0.001）及其他药物（OR=1.18,95%CI 1.13～1.22,P <0.001）的使用与DRG超支相关，而保肝药物、抑酸药物、镇痛药物及止吐药物的使用与DRG超支不存在相关性（P> 0.05）。结论 中成药、抗肿瘤药物、血细胞刺激因子及其他药物的使用与肿瘤患者DRG超支相关，临床应加强管控，降低药品费用，从而更好地适应DRG支付方式。

AIM To explore the association between drug use and diagnosis-related group(DRG) overspending in cancer patients, and to provide basis for controlling costs of drug use and rational drug use. METHODS Patients included in the RE1A disease group from January to December 2022 in a tertiary medical institution were used as the study data,and univariate Logistic regression and multivariate Logistic regression were used to assess the effect of different types of drugs on DRG overspending. RESULTS A total of 1 729 patients were included in the study and 431 patients presented with DRG overspending. The results of multivariable Logistic regression analyses revealed a significant association between the use of proprietary Chinese medicines(OR=1.09, 95%CI: 1.04-1.14, P<0.001), antineoplastic drugs(OR=1.07,95%CI: 1.06-1.08, P<0.001), haematocyte stimulating factors(OR=1.08, 95%CI: 1.05-1.10, P<0.001), and other medications(OR=1.18, 95%CI: 1.13-1.22, P<0.001) with DRG overspending. However, there was no correlation between hepatoprotective drugs, acid-suppressing drugs, analgesic drugs, and antiemetic drugs with DRG overspending(P>0.05).CONCLUSION The use of proprietary Chinese medicines, antineoplastic drugs, blood cell stimulating factors, and other kinds of drugs are associated with DRG overspending in oncology patients, and clinical control should be strengthened to reduce the cost of drugs, so as to better adapt to the DRG payment method.