Kolb K W, Israel M K
McGuire VA Medical Center.
Top Hosp Pharm Manage. 1991 Jul;11(2):44-50.
Although this paper has focused primarily on use of hospital-based databases for DUE purposes, the defunct Medicare Catastrophic Coverage Act did have provisions for ongoing prospective screening for drug interactions and adverse reactions among community Medicare prescriptions. The key to the proposed system was a point-of-service system that would have linked all Medicare pharmacies to a centralized database. This database would have been used for claims processing as well as quality management purposes. Many DUE functions at this time involve labor-intensive retrospective reviews that do not directly benefit or protect the particular patient involved. The future direction of DUE activity is concurrent screening that actively protects the patient from inappropriate prescribing. Use of computerized databases to assist in that process is a necessity.
尽管本文主要关注将基于医院的数据库用于药物利用评价目的，但已废止的《医疗保险灾难性保险法》确实有关于对社区医疗保险处方中的药物相互作用和不良反应进行持续前瞻性筛查的条款。所提议系统的关键是一个服务点系统，该系统会将所有医疗保险药房与一个中央数据库相连接。这个数据库本可用于理赔处理以及质量管理目的。此时许多药物利用评价功能涉及劳动密集型的回顾性审查，而这些审查并不能直接使相关特定患者受益或保护他们。药物利用评价活动的未来方向是进行同步筛查，以积极保护患者避免不恰当的处方。利用计算机化数据库来协助这一过程是必要的。
