三高重複給藥 一年浪費上億元

[chienchun]

三高重複給藥 一年浪費上億元

【聯合報╱記者詹建富／台北報導】
2013.04.22 03:07 am

許多心血管病患需終身服藥。健保局分析高血壓、高血脂及糖尿病等三高病患的用藥發現，每千名病人的處方中，平均有四到六張是醫師重複給藥，估計全年用藥浪費至少上億元。

健保局統計，國內三高病患約一百多萬人，為鼓勵醫藥分業，過去政府讓持有慢性病連續處方箋患者，每次就醫只需負擔掛號費，不必自付藥品部分負擔；有病患自認在甲醫院拿藥未發揮療效，就改到乙醫院看診。

日前健保局台北分局分析轄區各醫院所開立的三高病患口服藥處方箋發現，醫學中心的降血壓藥重複給藥比率最高，平均每一千張處方有七張開立相同藥；地區醫院的降血脂藥重複給藥比率雖較低，但每一千張也有兩張是同藥物。大體而言，三高病人每一千張處方有四到六張重複給藥。

健保局依據重複用藥比率推估，全台一年三高病人重複給藥所衍生的浪費金額，保守估計上億元。

健保局醫審及藥材小組組長沈茂庭說，已針對同院同醫師開立慢性病連續處方箋，若有重複給藥將不予給付。不過對於跨醫院就醫病人，現也要求各醫院應主動查詢三高患者的健保IC卡用藥紀錄。

【2013/04/22 聯合報】@ http://udn.com/



全文網址: 三高重複給藥 一年浪費上億元 | 醫藥新聞 | 健康醫藥 | 聯合新聞網 http://udn.com/NEWS/HEALTH/HEA1/7846547 ... z2R8vI4FFO
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[colonel]

三高重複給藥 一年浪費上億元

【聯合報╱記者詹建富／台北報導】
2013.04.22 03:07 am

健保局醫審及藥材小組組長沈茂庭說，已針對同院同醫師開立慢性病連續處方箋，若有重複給藥將不予給付。不過對於跨醫院就醫病人，現也要求各醫院應主動查詢三高患者的健保IC卡用藥紀錄。

【2013/04/22 聯合報】@ Power By udn.com

是要比照安眠藥模式,建立關懷名單是吧?

[image]

三高重複給藥 一年浪費上億元

【聯合報╱記者詹建富／台北報導】
2013.04.22 03:07 am

健保局醫審及藥材小組組長沈茂庭說，已針對同院同醫師開立慢性病連續處方箋，若有重複給藥將不予給付。不過對於跨醫院就醫病人，現也要求各醫院應主動查詢三高患者的健保IC卡用藥紀錄。

【2013/04/22 聯合報】@ Power By udn.com

是要比照安眠藥模式,建立關懷名單是吧?

健保IC卡查詢花的時間常比看診時間還高

要查可以 那大醫院名醫就剩一半的號可掛~民眾不滿意請找健保局

[旺大]

千錯萬錯一定都是醫師的錯
所以不給錢是合情合法天經地義的
G8G真是正義使者的化身！讚！ (挖鼻孔)

[wipten]

有種就 藥物全部自費

[李誠民]

Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administrative databases
BMJ2013;346doi: http://dx.doi.org/10.1136/bmj.f880(Published 19 March 2013)
Cite this as:BMJ2013;346:f880
Setting Seven Canadian provinces and two databases in the United Kingdom and the United States.
Participants 2 067 639 patients aged 40 years or older and newly treated with statins between 1 January 1997 and 30 April 2008……
Conclusions Use of high potency statins is associated with an increased rate of diagnosis for acute kidney injury in hospital admissions compared with low potency statins. The effect seems to be strongest in the first 120 days after initiation of statin treatment.

1.Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study
BMJ2013;346doi: http://dx.doi.org/10.1136/bmj.e8525(Published 8 January 2013)
Cite this as:BMJ2013;346:e8525
Biological mechanisms
…. This result is biologically consistent with the potential effect of a drastic hypovolaemia exerted by diuretics, which is further exacerbated by the vasoconstrictive effect of NSAIDs.7 21 31 On the other hand, among patients taking angiotensin converting enzyme inhibitors or angiotensin receptor blockers and NSAIDs (without a diuretic), the afferent vasoconstrictive stimulus induced by the NSAIDs through inhibition of prostacyclins synthesis is probably insufficient to substantially increase the risk of acute kidney injury in the presence of a normal extracellular fluid volume and preserved renal blood flow………
What is already known about this topic:
…The combination of one or two antihypertensive drugs (angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and diuretics) with non-steroidal anti-inflammatory drugs (NSAIDs) can theoretically increase the risk of acute kidney injury….

2.More evidence of nephrotoxicity with renin-angiotensin-aldosterone system blockers
BMJ2013;346doi: http://dx.doi.org/10.1136/bmj.f661(Published 19 February 2013)
Cite this as:BMJ2013;346:f661

3.The nephrotoxic “triple whammy” of combining diuretics, ACE inhibitors, and diuretics
BMJ2013;346doi: http://dx.doi.org/10.1136/bmj.f678(Published 19 February 2013)
Cite this as:BMJ2013;346:f678
健保局媒基本醫學知識,那能怪誰呢!?....提供給它...來亂刪基層醫師給付!!!門都沒有!!!

[jyuan]

怎麼不乾脆推動癈除健保了呢？
請這些健保"官員"做這些調查醫師的事情, 恐怕每年保守估計也是花費近億元吧？

http://bbs-mychat.com/reads.php?tid=645329

健保局員工3200人左右,
一般公務員月薪30000以上是常態, 保守估計平均只有30000,
一年就要花掉人民血汗錢9600萬(近億元無誤)~
再加上年終獎金, 應該輕鬆破億,
再加上到時退休要繼續養, 更是讓財政雪上加霜,
還沒計算員工薪水以外的開銷,
各地健保局大樓水電,
三不五時的廣告文宣費用.....

如果癈掉健保局, 每年不知道可以為全國人民省下多~少的納稅錢 (爽) (爽) (爽)

[min]

IC卡vpn只能查最近6次用藥，有用嗎？