- Journal Information
- Archive
- Submission
- For Reviewers
- Statement and Policies
- 个人中心
- 退出登录
浏览全部资源
扫码关注微信
- Journal Information
- Archive
- Submission
- For Reviewers
- Statement and Policies
Effectiveness of multi-department collaboration control based on rationality evaluation rule for antibiotics use under DRG
- ZHONGGUO YAOFANG Vol. 35, Issue 23, Pages: 2941-2947(2024)
- 作者机构：
1.安徽医科大学第一附属医院药学部，合肥 230032
2.安徽省公共卫生临床中心药学部，合肥 230032
- 作者简介：
- 基金信息：
DOI：10.6039/j.issn.1001-0408.2024.23.17
CLC： R969.3;R978.1Published：15 December 2024，
Received：26 June 2024，
Revised：04 November 2024，
- 稿件说明：
移动端阅览
邱昌露,毕红朋,代雪飞.基于DRG的抗菌药物使用合理性评价细则构建及多部门协作管控成效 Δ[J].中国药房,2024,35(23):2941-2947.
QIU Changlu,BI Hongpeng,DAI Xuefei.Effectiveness of multi-department collaboration control based on rationality evaluation rule for antibiotics use under DRG[J].ZHONGGUO YAOFANG,2024,35(23):2941-2947.
邱昌露,毕红朋,代雪飞.基于DRG的抗菌药物使用合理性评价细则构建及多部门协作管控成效 Δ[J].中国药房,2024,35(23):2941-2947. DOI： 10.6039/j.issn.1001-0408.2024.23.17.
QIU Changlu,BI Hongpeng,DAI Xuefei.Effectiveness of multi-department collaboration control based on rationality evaluation rule for antibiotics use under DRG[J].ZHONGGUO YAOFANG,2024,35(23):2941-2947. DOI： 10.6039/j.issn.1001-0408.2024.23.17.
摘要
目的
2
以呼吸系统感染/炎症的疾病诊断相关分组（DRG）为抓手，促进抗菌药物的合理使用。
方法
2
创建呼吸系统感染/炎症患者抗菌药物临床使用合理性评价细则（包括药物选择、集采品种、用法用量等12项评价指标），并运用属性层次模型赋予各指标评分权重。采用加权优劣解距离（TOPSIS）法对2021年1－9月（多部门协作管控前，对照组）的102例及2022年1－9月（多部门协作管控后，干预组）的103例用药情况进行综合评价；计算各评价指标与最优方案的相对接近度，并比较多部门协作管控前后抗菌药物使用合理性、抗菌药物相关评估指标、卫生经济评估指标及诊疗结局相关指标的差异。
结果
2
在抗菌药物使用中，干预组患者抗菌药物总体使用不合理率、平均累计限定日剂量（DDD）及联合用药使用率均较对照组显著降低（
P
＜0.05）；在卫生经济评估指标中，干预组患者的次均抗菌药物费用及次均住院费用均较对照组显著降低（
P
＜0.05）；在诊疗结局相关指标中，干预组患者的平均住院天数较对照组显著减少（
P
＜0.05），但两组间临床疗效并无明显差异（
P
＞0.05）。进一步组间比较发现，在平均累计DDD上，对于ES31、ES33及ES35病组，干预组患者较对照组均显著降低（
P
＜0.05）；在联合用药使用率上，对于ES31、ES35病组，干预组患者较对照组均显著降低（
P
＜0.05）；在次均抗菌药物费用上，对于ES35病组，干预组患者较对照组显著降低（
P
＜0.05），且干预组中ES35、ES33病组患者的次均抗菌药物费用均显著低于ES31病组（
P
＜0.05）。
结论
2
基于DRG构建的呼吸系统感染/炎症患者抗菌药物临床使用合理性评价细则，可对抗菌药物使用合理性进行综合评价；多部门协作管控可提高抗菌药物使用合理性，降低医疗费用的支出。
Abstract
OBJECTIVE
2
To promote rational use of antibiotics taking diagnosis related group （DRG） of respiratory system infection/inflammation as a starting point.
METHODS
2
The rules for evaluating the rationality of clinical use of antibiotics in patients with respiratory system infection/inflammation were established（including 12 evaluation indicators such as drug selection， centrally procured varieties， usage and dosage）， and the attribute hierarchy model was applied to assign scoring weights to each indicator. A total of 102 cases from January to September 2021 （before multi-department collaboration and control， as control group） and 103 cases from January to September 2022 （after multi-department collaboration and control， as interention group） were comprehensively evaluated by weighted pros and cons method. The relative proximity （
C
i
） between each evaluation index and the optimal scheme was calculated， and the rationality of the use of antibacterial， antibacterial drug related index， health economic evaluation index and diagnosis and treatment outcome index were compared before and after multi-department collaboration control.
RESULTS
2
In the use of antibiotics， the irrational rate of antibiotics use， the average cumulative defined daily dose （DDD） and the utilization rate of combined drugs in the intervention group were significantly lower than control group （
P
＜0.05）. In the indicators of health economic evaluation， the average cost of antibiotics per time and average cost of hospitalization per time in the intervention group were significantly lower than control group （
P
＜0.05）. In the relevant indicators of diagnosis and treatment outcome， the average hospitalization days of patients in the intervention group were significantly lower than control group （
P
＜0.05）， but the clinical efficacy was not significantly different （
P
＞0.05）. Further comparison between groups
showed that the average cumulative DDD of ES31， ES33 and ES35 patients in the intervention group was significantly lower than control group （
P
＜0.05）. The utilization rate of combined drugs in ES31 and ES35 patients was significantly lower in the intervention group than control group. In the ES35 disease group （
P
＜0.05）， the average cost of antibiotics per time in the intervention group was significantly lower than control group （
P
＜0.05）， and the cost of antibiotics per time of ES35 and ES33 disease groups in the intervention group were significantly lower than ES31 disease group （
P
＜0.05）.
CONCLUSIONS
2
The rational evaluation rules for the clinical application of antibiotics in patients with respiratory system infection/inflammation based on DRG are successfully established， which can be used for comprehensive evaluation of the use of antibiotics； multi-department collaboration control can improve the rational rate of antibiotic use and reduce the medical cost.
关键词
疾病诊断相关分组多部门协作管控加权TOPSIS法呼吸系统感染/炎症抗菌药物合理性评价
Keywords
multi-department cooperation controlweighted TOPSIS methodrespiratory system infection/inflammationantibioticsrationality evaluation
references
武华军，陈永刚，涂少辉，等. 基于疾病诊断相关分组的烧伤科抗菌药物精细化管理探索[J]. 中国药房，2022，33（15）：1901-1904.
WU H J，CHEN Y G，TU S H，et al. Exploration on fine management of antibiotics in burn department based on disease diagnosis related groups[J]. China Pharm，2022，33（15）：1901-1904.
国家卫生健康委，教育部，科技部，等.关于印发遏制微生物耐药国家行动计划（2022－2025年）的通知：国卫医函〔2022〕185号[EB/OL]．（2022-10-28）[2024-04-12].http：//www.nhc.gov.cn/yzygj/s7659/202210/2875ad7e2b-2e46a2a672240ed9ee750f.shtmlhttp://www.nhc.gov.cn/yzygj/s7659/202210/2875ad7e2b-2e46a2a672240ed9ee750f.shtml.
National Health Commission，Ministry of Education，Mi- nistry of Science and Technology，et al. Notice on issuing the national action plan for containing microbial drug resistance （2022-2025）[EB/OL]．（2022-10-28）[2024-04-12].http：//www.nhc.gov.cn/yzygj/s7659/202210/2875ad-7e2b2e46a2a672240ed9ee750f.shtmlhttp://www.nhc.gov.cn/yzygj/s7659/202210/2875ad-7e2b2e46a2a672240ed9ee750f.shtml.
王桂凤，李雪芹，刘锐锋，等. 基于加权TOPSIS法的硫酸多黏菌素B药物利用评价[J]. 中国医院药学杂志，2022，42（3）：324-328.
WANG G F，LI X Q，LIU R F，et al. Drug use evaluation of polymyxin B sulphas for injection based on weighted TOPSIS method[J]. Chin J Hosp Pharm，2022，42（3）：324-328.
杨万枝，胡章海，解雪峰，等.基于加权TOPSIS法的急性胰腺炎患者抗菌药物应用合理性评价[J]. 中国医院用药评价与分析，2021，21（7）：853-857.
YANG W Z，HU Z H，XIE X F，et al. Evaluation on application rationality of antibiotics in patients with acute pancreatitis based on weighted TOPSIS method[J]. Eval Anal Drug Use Hosp China，2021，21（7）：853-857.
卫生部. 抗菌药物临床应用管理办法[J]. 中华临床感染病杂志，2012，5（4）：193-196.
Ministry of Health.Regulations for clinical application of antibacterial agents[J]. Chin J Clin Infect Dis，2012，5（4）：193-196.
《抗菌药物临床应用指导原则》修订工作组. 抗菌药物临床应用指导原则：2015年版[M]. 北京：人民卫生出版社，2015：2-3.
Guidelines for Clinical Use of Antibiotics Revision wor- king group. Guidelines for clinical use of antibiotics：2015 edition[M]. Beijing：People’s Medical Publishing House，2015：2-3.
中华医学会呼吸病学分会.中国成人社区获得性肺炎诊断和治疗指南：2016年版[J]. 中华结核和呼吸杂志，2016，39（4）：253-279.
Chinese Medical Association Respiratory Branch.Guidelines for diagnosis and treatment of adult community-acquired pneumonia in China：2016 edition [J]. Chin J Tuberc Respir Dis，2016，39（4）：253-279.
于翠香，王西艳. 《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南（2018年版）》解读[J]. 中国医刊，2021，56（9）：951-953.
YU C X，WANG X Y. Interpretation of China Adult Hospital-acquired Pneumonia and Ventilator-associated Pneumonia Diagnosis and Treatment Guidelines （2018 Edition）[J]. Chin J Med，2021，56（9）：951-953.
谢奕丹，吴晓玲，黄光鸿，等.社区获得性肺炎住院患者抗菌药物合理使用专项点评标准的建立与应用效果评价[J].中国药房，2017，28（2）：262-266.
XIE Y D，WU X L，HUANG G H，et al. Establishment and effects evaluation of special evaluation standard for antibiotics rational use in the inpatients with community-acquired pneumonia[J]. China Pharm，2017，28（2）：262-266.
《抗菌药物临床试验技术指导原则》写作组. 抗菌药物临床试验技术指导原则[J]. 中国临床药理学杂志，2014，30（9）：844-856.
Writing Group of Guidance for Clinical Trials of Anti-bacterial Drugs. Guidance for clinical trials of anti-bacterial drugs[J]. Chin J Clin Pharmacol，2014，30（9）：844-856.
杨荣，张晓沁.某院119例社区获得性肺炎患者临床抗菌药物治疗的合理性及不合理原因分析[J].抗感染药学，2021，18（7）：986-989.
YANG R，ZHANG X Q. Analysis of rationality and unreasonable reasons of clinical antibacterial therapy in 119 patients with community-acquired pneumonia in a hospital[J]. Anti Infect Pharm，2021，18（7）：986-989.
喻玮，肖永红.正确认识联合用药治疗耐药菌感染[J].医药导报，2019，38（7）：835-842.
YU W，XIAO Y H. Proper understanding on the combined medication for the therapy of resistant bacterial infection[J] .Her Med，2019，38（7）：835-842.
葛欣，刘平，张士伟，等. 基于DRG支付的药事管理干预对基层医院静脉输液合理使用的影响[J]. 中国药业，2024，33（2）：6-10.
GE X，LIU P，ZHANG S W，et al. Effect of pharmaceutical administration intervention based on DRG payment on the rational use of intravenous infusion in primary hospitals[J]. China Pharm，2024，33（2）：6-10.
恽琴素，周伟贤，徐卉，等.基于数据挖掘技术优化DRG临床用药目录[J].中国药房，2024，35（13）：1558-1563.
YUN Q S，ZHOU W X，XU H，et al. Optimization of the clinical drug list of DRG based on data mining technology[J]. China Pharm ，2024，35（13）：1558-1563.
郭永丽，曾跃萍，王心雨，等.基于大数据的CN-DRG儿童分组年龄优化研究[J]. 慢性病学杂志，2020，21（10）：1455-1457.
GUO Y L，ZENG Y P，WANG X Y，et al. Study on age optimization of children CN-DRG based on big data[J]. Chronic Pathematology J，2020，21（10）：1455-1457.
0
Views
0
下载量
0
CSCD
- L-PDFDownload
- WORDDownload
- Meta-XMLDownload
- BibTeXDownload
- EndnoteDownload
- RefMan Download
- NoteExpressDownload
- NoteFirstDownload
Publicity Resources
Related Articles
Related Author
Related Institution
- Address：8th Floor, Sihuan Building, No. 129 Daping Main Street, Yuzhong District, Chongqing, China Postal code：400042
- Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号
公网安备50010302001817 - It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
- Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.