| 特集名 | 透析患者の薬物の処方とモニタリング | |
|---|---|---|
| 題名 | 保険診療と特定薬剤管理 | |
| 発刊年月 | 1999年 11月 | |
| 著者 | 山崎 親雄 | 増子記念病院 |
| 【 要旨 】 | 透析患者の病態や合併症は多彩で，薬剤の使用も多い． 日本透析医会(Japanese Association of Dialysis Phisicians)の調査では，外来透析患者について，全透析医療費に占める薬剤比率は15.1％であり，厚生省報告の一般外来診療時の薬剤比率24.9％を大きく下回っている． 一方，厚生省は，傷病別に，薬剤点数別件数の構成比率を示しているが，1,000点/月以上の薬剤が処方される割合は，全体では18.9％であるが，腎不全では62.9％と高率である．また，投薬される薬剤種類も，全体では8種類以上の処方割合が5.9％であるのに対して，腎不全では40.8％と高率で，1件当りの調剤種類数も，全体の平均では3.27種類であるが，腎不全では，7.47種類と倍以上になっている． |
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| Theme | Prescription of Therapeutics and Monitoring for the Dialysis Patients | |
|---|---|---|
| Title | Prescription for maintenance hemodialysis patients in Japanese health care | |
| Author | Chikao Yamazaki | Masuko Memorial Hospital |
| [ Summary ] | Clinical profiles and complications in patients undergoing dialysis treatment are varied, therefore, many kinds of drugs are necessary for proper management of dialysis patients. The cost ratio for drugs, related to total medical expenditurs for dialysis treatment is reported to be only 15.1%, according to a survey performed by the Japanese Association of Dialysis Physicians. However, for average patients at hospitals and/or clinics, as outpatients the rate is 24.9%, according to the Annual Report from the Ministry of Public Welfare. Thus, expense for drugs is considerably lower for dialysis treatment compared with outpatients, as a whole. The Ministry of Public Welfare annually reports the distribution ratio of drug costs, separated by type of disease, and it indicates that the rates for cases with drug cost of more than 1,000 points/month is 18.9% over all, but the value in dialysis treatment is 62.9%. This suggests that the medical expenses for dialysis treatment are high, compared to those of for normal outpatient clinics. Regarding the kind of drug prescribed, the distribution ratio in cases with more than 8 types of drug is 5.9% over all, but it is 40.8% in dialysis treatment. The average number of drug prescriptions per case is 3.27 over all, but is 7.47 in dialysis treatment. This suggests that patients undergoing dialysis treatment need a high number of medications |
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