Purpose: Multiple diseases are often found in an elderly person concurrently, and most are chronic diseases. A wide variety of drugs are available for treatment but have prominent drugs interaction problems. Our research and development pharmacovigilance system (PVS) for the detection of potentially inappropriate medication (PIM) is a novel alert system which for reducing PIM prescriptions of elderly patients. The aim of this study was to evaluate the effect of a PVS on PIM prescriptions for elderly patients in our hospital. Methods: All drugs that pose risks to elderly patients, risk reasons, grade of recommendation in the guidelines and consensus were concluded, incorporated and summarised as the document information of the PVS for elderly patients. It was imported into the hospital information system (HIS) in batches. The real time audit of different dimensions will be conducted on the medical orders issued according to the different contents of the entries in the PVS. Results: The PVS has been applied into trial operation in the five geriatric departments of our hospital. The PVS for elderly patients has provided warnings 3911 times on outpatient and 3999 times on inpatient for six months. PVS had great influence on the usage of sedatives and hypnotics (estazolam, clonazepam, diazepam, zolpidem, alprazolam). The overall prevalence of PIM was significantly decreased during the 6 months. In January, warning percentage was 16.15% on outpatients and 30.59% on intpatients. However, warning percentage was 6.70% on outpatients and 16.06% on intpatients in June. Conclusions: The combination of the information platform and PIM could provide deeper technical support for the safety of medical behaviour and individualised treatment of patients.

Purpose: This study aimed to evaluate the influence of DRG-based hospital payment system approach on implementation of inpatient treatment. Methods: This study was largely based on retrospective analysis of DRG-based hospital payment data from third-class hospital for the period of October 2021 to February 2022 including determination of diagnosis groups with most significant balance of payment loss and corresponding departments, development of pathways to DRG-based inpatient treatment, pre-checking of prescriptions, in process education of clinical pharmacists and case follow up, comments and penalty measures. The rational drug use, drug income proportion and DRG-related medical services capability assessment (manageable number of DRGs, CMI, average hospital stay, time consumption index and resource consumption index) of departments with loss were compared before and after intervention. Results: Data analysis revealed that BR23 (cerebral ischemic stroke with accompanying diseases or complications) balance of payments loss was most significant with higher average drug income proportion than such in groups of balance of payments surplus. The Neurology Department BR23 demonstrated significant balance of payment deficit. Therefore, the ischemic stroke drug clinical treatment pathway was successfully developed and after intervention, prescription errors counted 14.14, therefore demonstrated 6.89% decrease and at the same time medicines consumption rate was 27.17% with 9.43% decrease. The number of manageable number of DRGs increased by 3, CMI increased by 0.14, average length of stay decreased by 0.8 days, time consumption index and resource consumption index decreased by 0.11 and 0.18 respectively. Conclusion: DRG-based hospital payment management of inpatient treatment provided theoretical support for DRG code-based reimbursement cost control and scientific cost control and has improved quality management of hospital service.