UNIVERSITATEA DE MEDICINĂ ŞI FARMACIE TÂRGU MUREŞ

“MANAGEMENTUL SERVICIILOR DE SĂNĂTATE “

Diagrama Pareto

Coordonator
Dr. Liviu Marian

Cursant
Cristina Andra Chiluţ

1
 Conducerea Spitalului Clinic Judeţean de Urgenţă Tg. Mureş, dorește să clasifice și să
ierarhizeze consumul de medicamente din grupa antibioticelor în funcție de costurile aferente
fiecăruia astfel încăt să aibă un tablou generalizator care să clasifice medicamentele după aportul lor
la costurile totale pentru a elabora o politică de aprovizionare și stocare cât mai eficientă fără
imobilizări de fonduri în stocuri sau medicamente ieșite din termenele de utilizare.

-A fost cumulat într-un tabel centralizator consumul de medicamente din grupa antibioticelor din
unitate cu calculul costurilor aferente fiecărui medicament (tab.1)

Cantitate
Nr. totala Valoare
Crt. Denumire medicament UM consumata totala
1 AMOXICILINA 500MG CPS CAPS 4,444.00 1,695.39
AMOXIPLUS 1000 mg/200 mg PULB.
2 PT. SOL. INJ./PERF. FL 4.00 26.68
3 AMPICILINA 1G FL FL. 7,440.00 13,543.03
4 AMPICILINA 250MG FL FL 1,424.00 2,048.85
5 AMPICILINA 500 MG FORTE CPS CAPS 3,636.00 1,387.14
6 AMPIPLUS 1,5G FL FL. 9,280.00 119,854.66
7 AUGMENTIN ES 642.9MG/5ML FL. FLAC 4.00 110.92
AUGMENTIN SR 1000 MG/62,5 MG
8 COMPR. ELIB. PREL. COMP 4,388.00 5,978.65
9 AVELOX 400 mg COMPR. FILM. COMP 480.00 1,721.33
10 CEFORT 1 g PULB. PT. SOL. INJ. FL. 95,100.00 211,002.77
11 CEFTAMIL 1G FL FL. 47,220.00 132,277.38
12 CEFUROXIMA ANTIBIOTICE 1,5G FL FL. 19,260.00 78,515.32
13 CIFRAN 500MG CPR. COMP 6,636.00 2,025.31
14 CIPROFLOXACINA 100MG/10ML F F 31,772.00 66,799.21
15 CLINDAMYCIN 300MG/2ML F F 9,860.00 43,576.41
16 COLISTINA 1MIL U.I. FL FL. 18,240.00 305,580.19
17 GENTAMICINA 80 MG F F 3,252.00 2,162.26
18 GENTAMICINA 80 MG F F 9,624.00 5,769.59
IMIPENEM/CILASTATIN KABI
19 500MG/500MG FL FL 4,764.00 58,678.19
20 LEVOFLOXACIN KABI 5MG/ML FL FLAC. 1,436.00 29,739.56
21 LINEZOLID TEVA 2 MG/ML 300ML PUNGI 1,364.00 117,454.04
22 MEROPENEM ANTB. 1G FL FL. 8,848.00 139,842.64
23 MEROPENEM KABI 500MG FL FL 1,380.00 19,674.94
MOXIFLOXACINA KABI 400MG/250
24 ML FL. 228.00 11,230.62
25 OXACILINA 500MG FL FL. 2,568.00 9,433.04
PENICILINA G SODICA PULB. PT.
26 SOL. INJ. 1 000 000ui FLAC 6,992.00 22,482.78
PIPERACILINA +TAZOBACTAM 4,5G
27 KABI FL FL 352.00 6,821.83
28 SULCEF 1G+1G FL FL 14,032.00 265,672.06
29 SUMETROLIM 400/80 COMP. COMP 11,616.00 3,003.80
30 TARGOCID 400 MG FL FL 1,192.00 119,754.64
31 TYGACIL 50MG FL FL 576.00 108,660.27
32 VANCOMICINA KABI 1G FL FL 2,764.00 63,539.11
33 ZYVOXID SOL.PERF. 2MG/ML PUNGI 688.00 59,243.68

2
 300ML
TOTAL 2,029,306.26

-s-a reordonat tabelul realizat anterior în ordinea descrescătoare a valorii totale pe fiecare
antibiotic ( tab.2)

Cantitate
Nr. totala
Crt. Denumire medicament UM consumata Valoare totala
16 COLISTINA 1MIL U.I. FL FL. 18,240.00 305,580.19
28 SULCEF 1G+1G FL FL 14,032.00 265,672.06
10 CEFORT 1 g PULB. PT. SOL. INJ. FL. 95,100.00 211,002.77
22 MEROPENEM ANTB. 1G FL FL. 8,848.00 139,842.64
11 CEFTAMIL 1G FL FL. 47,220.00 132,277.38
6 AMPIPLUS 1,5G FL FL. 9,280.00 119,854.66
30 TARGOCID 400 MG FL FL 1,192.00 119,754.64
21 LINEZOLID TEVA 2 MG/ML 300ML PUNGI 1,364.00 117,454.04
31 TYGACIL 50MG FL FL 576.00 108,660.27
12 CEFUROXIMA ANTIBIOTICE 1,5G FL FL. 19,260.00 78,515.32
14 CIPROFLOXACINA 100MG/10ML F F 31,772.00 66,799.21
32 VANCOMICINA KABI 1G FL FL 2,764.00 63,539.11
ZYVOXID SOL.PERF. 2MG/ML
33 300ML PUNGI 688.00 59,243.68
IMIPENEM/CILASTATIN KABI
19 500MG/500MG FL FL 4,764.00 58,678.19
15 CLINDAMYCIN 300MG/2ML F F 9,860.00 43,576.41
20 LEVOFLOXACIN KABI 5MG/ML FL FLAC. 1,436.00 29,739.56
PENICILINA G SODICA PULB. PT.
26 SOL. INJ. 1 000 000ui FLAC 6,992.00 22,482.78
23 MEROPENEM KABI 500MG FL FL 1,380.00 19,674.94
3 AMPICILINA 1G FL FL. 7,440.00 13,543.03
MOXIFLOXACINA KABI 400MG/250
24 ML FL. 228.00 11,230.62
25 OXACILINA 500MG FL FL. 2,568.00 9,433.04
PIPERACILINA +TAZOBACTAM 4,5G
27 KABI FL FL 352.00 6,821.83
AUGMENTIN SR 1000 MG/62,5 MG
8 COMPR. ELIB. PREL. COMP 4,388.00 5,978.65
18 GENTAMICINA 80 MG F F 9,624.00 5,769.59
29 SUMETROLIM 400/80 COMP. COMP 11,616.00 3,003.80
17 GENTAMICINA 80 MG F F 3,252.00 2,162.26
4 AMPICILINA 250MG FL FL 1,424.00 2,048.85
13 CIFRAN 500MG CPR. COMP 6,636.00 2,025.31
9 AVELOX 400 mg COMPR. FILM. COMP 480.00 1,721.33
1 AMOXICILINA 500MG CPS CAPS 4,444.00 1,695.39
5 AMPICILINA 500 MG FORTE CPS CAPS 3,636.00 1,387.14
7 AUGMENTIN ES 642.9MG/5ML FL. FLAC 4.00 110.92
AMOXIPLUS 1000 mg/200 mg PULB.
2 PT. SOL. INJ./PERF. FL 4.00 26.68
TOTAL 2,029,306.26

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 - s- creat un nou tabel cu valoarea cumulată dintre valoarea totală a articolelor anterioare
și articolul curent(tab.3)

Cantitate
Nr. totala Valoare Valoare
Crt. Denumire medicament UM consumata totala cumulata
16 COLISTINA 1MIL U.I. FL FL. 18,240.00 305,580.19 305,580.19
28 SULCEF 1G+1G FL FL 14,032.00 265,672.06 571,252.26
10 CEFORT 1 g PULB. PT. SOL. INJ. FL. 95,100.00 211,002.77 782,255.02
22 MEROPENEM ANTB. 1G FL FL. 8,848.00 139,842.64 922,097.66
11 CEFTAMIL 1G FL FL. 47,220.00 132,277.38 1,054,375.05
6 AMPIPLUS 1,5G FL FL. 9,280.00 119,854.66 1,174,229.70
30 TARGOCID 400 MG FL FL 1,192.00 119,754.64 1,293,984.34
21 LINEZOLID TEVA 2 MG/ML 300ML PUNGI 1,364.00 117,454.04 1,411,438.38
31 TYGACIL 50MG FL FL 576.00 108,660.27 1,520,098.65
12 CEFUROXIMA ANTIBIOTICE 1,5G FL FL. 19,260.00 78,515.32 1,598,613.96
14 CIPROFLOXACINA 100MG/10ML F F 31,772.00 66,799.21 1,665,413.18
32 VANCOMICINA KABI 1G FL FL 2,764.00 63,539.11 1,728,952.28
ZYVOXID SOL.PERF. 2MG/ML
33 300ML PUNGI 688.00 59,243.68 1,788,195.96
IMIPENEM/CILASTATIN KABI
19 500MG/500MG FL FL 4,764.00 58,678.19 1,846,874.15
15 CLINDAMYCIN 300MG/2ML F F 9,860.00 43,576.41 1,890,450.56
20 LEVOFLOXACIN KABI 5MG/ML FL FLAC. 1,436.00 29,739.56 1,920,190.12
PENICILINA G SODICA PULB. PT.
26 SOL. INJ. 1 000 000ui FLAC 6,992.00 22,482.78 1,942,672.90
23 MEROPENEM KABI 500MG FL FL 1,380.00 19,674.94 1,962,347.84
3 AMPICILINA 1G FL FL. 7,440.00 13,543.03 1,975,890.87
MOXIFLOXACINA KABI 400MG/250
24 ML FL. 228.00 11,230.62 1,987,121.49
25 OXACILINA 500MG FL FL. 2,568.00 9,433.04 1,996,554.52
PIPERACILINA +TAZOBACTAM 4,5G
27 KABI FL FL 352.00 6,821.83 2,003,376.36
AUGMENTIN SR 1000 MG/62,5 MG
8 COMPR. ELIB. PREL. COMP 4,388.00 5,978.65 2,009,355.01
18 GENTAMICINA 80 MG F F 9,624.00 5,769.59 2,015,124.60
29 SUMETROLIM 400/80 COMP. COMP 11,616.00 3,003.80 2,018,128.39
17 GENTAMICINA 80 MG F F 3,252.00 2,162.26 2,020,290.65
4 AMPICILINA 250MG FL FL 1,424.00 2,048.85 2,022,339.50
13 CIFRAN 500MG CPR. COMP 6,636.00 2,025.31 2,024,364.81
9 AVELOX 400 mg COMPR. FILM. COMP 480.00 1,721.33 2,026,086.14
1 AMOXICILINA 500MG CPS CAPS 4,444.00 1,695.39 2,027,781.52
5 AMPICILINA 500 MG FORTE CPS CAPS 3,636.00 1,387.14 2,029,168.66
7 AUGMENTIN ES 642.9MG/5ML FL. FLAC 4.00 110.92 2,029,279.58
AMOXIPLUS 1000 mg/200 mg PULB.
2 PT. SOL. INJ./PERF. FL 4.00 26.68 2,029,306.26

- s-a calculat procentajul aferent valorii cumulate și valoarea totală a medicamentelor

antibiotice (tab.4)

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 Cantitate Procent
Nr. totala Valoare Valoare Valoare
Crt. Denumire medicament consumata totala cumulata cumulata
16 COLISTINA 1MIL U.I. FL 18,240.00 305,580.19 305,580.19 15.058%
28 SULCEF 1G+1G FL 14,032.00 265,672.06 571,252.26 28.150%
10 CEFORT 1 g PULB. PT. SOL. INJ. 95,100.00 211,002.77 782,255.02 38.548%
22 MEROPENEM ANTB. 1G FL 8,848.00 139,842.64 922,097.66 45.439%
11 CEFTAMIL 1G FL 47,220.00 132,277.38 1,054,375.05 51.957%
6 AMPIPLUS 1,5G FL 9,280.00 119,854.66 1,174,229.70 57.864%
30 TARGOCID 400 MG FL 1,192.00 119,754.64 1,293,984.34 63.765%
21 LINEZOLID TEVA 2 MG/ML 300ML 1,364.00 117,454.04 1,411,438.38 69.553%
31 TYGACIL 50MG FL 576.00 108,660.27 1,520,098.65 74.907%
12 CEFUROXIMA ANTIBIOTICE 1,5G FL 19,260.00 78,515.32 1,598,613.96 78.776%
14 CIPROFLOXACINA 100MG/10ML F 31,772.00 66,799.21 1,665,413.18 82.068%
32 VANCOMICINA KABI 1G FL 2,764.00 63,539.11 1,728,952.28 88.119%
ZYVOXID SOL.PERF. 2MG/ML
33 300ML 688.00 59,243.68 1,788,195.96 88.119%
IMIPENEM/CILASTATIN KABI
19 500MG/500MG FL 4,764.00 58,678.19 1,846,874.15 91.010%
15 CLINDAMYCIN 300MG/2ML F 9,860.00 43,576.41 1,890,450.56 93.157%
20 LEVOFLOXACIN KABI 5MG/ML FL 1,436.00 29,739.56 1,920,190.12 94.623%
PENICILINA G SODICA PULB. PT.
26 SOL. INJ. 1 000 000ui 6,992.00 22,482.78 1,942,672.90 95.731%
23 MEROPENEM KABI 500MG FL 1,380.00 19,674.94 1,962,347.84 96.700%
3 AMPICILINA 1G FL 7,440.00 13,543.03 1,975,890.87 97.368%
MOXIFLOXACINA KABI 400MG/250
24 ML 228.00 11,230.62 1,987,121.49 97.921%
25 OXACILINA 500MG FL 2,568.00 9,433.04 1,996,554.52 98.386%
PIPERACILINA +TAZOBACTAM 4,5G
27 KABI FL 352.00 6,821.83 2,003,376.36 98.722%
AUGMENTIN SR 1000 MG/62,5 MG
8 COMPR. ELIB. PREL. 4,388.00 5,978.65 2,009,355.01 99.017%
18 GENTAMICINA 80 MG F 9,624.00 5,769.59 2,015,124.60 99.301%
29 SUMETROLIM 400/80 COMP. 11,616.00 3,003.80 2,018,128.39 99.449%
17 GENTAMICINA 80 MG F 3,252.00 2,162.26 2,020,290.65 99.556%
4 AMPICILINA 250MG FL 1,424.00 2,048.85 2,022,339.50 99.657%
13 CIFRAN 500MG CPR. 6,636.00 2,025.31 2,024,364.81 99.756%
9 AVELOX 400 mg COMPR. FILM. 480.00 1,721.33 2,026,086.14 99.841%
1 AMOXICILINA 500MG CPS 4,444.00 1,695.39 2,027,781.52 99.925%
5 AMPICILINA 500 MG FORTE CPS 3,636.00 1,387.14 2,029,168.66 99.993%
7 AUGMENTIN ES 642.9MG/5ML FL. 4.00 110.92 2,029,279.58 99.999%
AMOXIPLUS 1000 mg/200 mg PULB.
2 PT. SOL. INJ./PERF. 4.00 26.68 2,029,306.26 100.000%

- s-a realizat in EXCEL diagrama Pareto

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Diagrama Pareto sau diagrama ABC împarte evenimentele în trei categorii:

categoria A – evenimente puţine, aproximativ 20% din total care au o consecință cumulată de 80%
Aceste evenimente sunt principala sursă de probleme , vor fi analizate cu prioritate şi cu o
periodicitate foarte ridicată

Analizând datele, conducerea Spitalului Clinic Județean de Urgență Tg. Mureș concluzionează că
trebuiesă analizeze cu periodicitate, consumul antibioticului COLISTINA 1MIL U.I. FL, acesta
reprezentând 15,058% din consumul total al antibioticelor.