OBJECTIVE: To standardize the rational drug use behavior of medical insurance physicians through prescription reviews

so as to avoid the medical insurance violations and reduce the rate of medical insurance refusal.METHODS: In Jul. 2020

the medical insurance management department

pharmacy department and outpatient department of Shenzhen Bao ’ an Maternal and Child Health Hospital（ hereinafter referred to as “our hospital ”）performed the review of the prescriptions of outpatient medical insurance physicians. Through the hospital information system

197 200 outpatient medical insurance prescriptions before intervention（ from Jan. to May 2020） and 384 688 outpatient medical insurance prescriptions after intervention（ from Jan.to May 2021） were extracted.The data of illegal use of restricted medical insurance drugs and refusal of payment of medical insurance drugs in outpatient medical insurance prescriptions before and after joint prescription review were reviewed and analyzed. RESULTS: Compared with before intervention（ from Jan.to May 2020）

the number of prescription refused by medical insurance in outpatient department of our hospital decreased by 99. 50%（ from 1 602 prescriptions to 8 prescriptions） after intervention（ from Jan.to May 2021）; the cost of drugs refused by medical insurance decreased by 99. 71%（ from 114 556. 78 yuan to329. 29 yuan）; the number of departments where medical insurance violation methods are over-range medication decreased by 81. 82%（ from 11 departments to 2 departments）; the number of drugs used in violation of medical insurance coverage decreased by 75. 00%（ from 4 drugs to 1 drug）.CONCLUSIONS: Through the joint supervision and control of medical insurance and pharmacy

and the prescription review system

the indications of medical insurance restrictive use of drugs can be included in the prescription review

which can ensure the clinical rational use of drugs

avoid medical insurance violations

regulate clinical drug use and avoid the occurrence of medical insurance refusal

so as to reasonably control the cost of medical insurance drugs and ensure the continuous and healthy development of medical insurance system.