三级甲等医院抗菌药物管理政策干预影响

发布时间：2018-01-18 03:33

本文关键词：三级甲等医院抗菌药物管理政策干预影响　出处：《中国公共卫生》2017年07期 　论文类型：期刊论文

【摘要】：目的了解2011—2015年第三季度全国183家三级甲等医院住院患者抗菌药物的使用情况,评价政策干预效果并发现问题,为指导下一步政策干预提供方向。方法通过国家抗菌药物临床应用监测网收集2011—2015年第三季度全国183家三级甲等医院住院患者抗菌药物使用数据,从品种数量、消耗金额、用药频度(DDDs)、金额和DDDs序号比4个方面进行综合分析。结果 2011—2015年第三季度抗菌药物品种数量减少129种,减幅最大的药物是喹诺酮类抗菌药物;抗菌药物消耗金额和DDDs在2011—2012年下降幅度最大,分别下降24.98%和15.92%,后又呈增加趋势,其中消耗金额回升较快。头孢菌素类抗菌药物在不同年度品种数量、消耗金额和DDDs各维度占比均最高,平均占比分别为25.85%、38.80%和46.35%。2011—2015年,碳青霉烯类和其他β-内酰胺类(氨曲南)抗菌药物消耗金额逐年升高,增长率从12.20%上升到22.53%,美罗培南消耗金额占比稳居全体抗菌药物金额费用第一位,2015年前三季度占比达到8.23%,从2013年开始,亚胺培南/西司他汀钠稳居第二位,2015年前三季度占比达到4.93%。左氧氟沙星和头孢呋辛稳居各年度DDDs消耗占比前两位且有继续增加趋势,2015年前三季度占比分别为9.04%和5.91%。各年度不同类别抗菌药物使用金额与DDDs排序比平均值最大的是喹诺酮类抗菌药物(2.40),最小的是碳青霉烯类和其他β-内酰胺类药物(氨曲南)(0.39)。结论一系列抗菌药物管理政策实施后,医疗机构对抗菌药物品种数量和用药频度控制有效果,但是金额控制比较乏力。头孢菌素类是三级医院使用最多的抗菌药物,限制使用级和特殊使用级抗菌药物使用增加,加重了患者负担。
[Abstract]:Objective to investigate the use of antimicrobial drugs in 183 Grade 3A hospitals in the third quarter of 2011-2015, to evaluate the effect of policy intervention and to find out the problems. Methods the use of antimicrobial drugs was collected through the National Monitoring Network for Clinical use of Antimicrobial drugs in 183 Grade 3A Hospitals in the third quarter of 2011-2015. Data. From the number of varieties, consumption of money, drug use frequency of DDDs). Results in the third quarter of 2011-2015, the number of antimicrobial drugs decreased by 129.The biggest decrease was quinolones. The amount of antimicrobial consumption and DDDs decreased by 24.98% and 15.92 respectively in 2011-2012, and then showed an increasing trend. The consumption amount of cephalosporins was the highest in the number of varieties, the consumption amount and the proportion of DDDs in each dimension, and the average ratio was 25.85%, respectively. Between 38.80% and 46.35 and 2011-2015, the consumption of carbapenems and other 尾 -lactam antibiotics (aztreonam) increased year by year. The growth rate rose from 12.20% to 22.53.The amount of meropenem consumption ranked first in the total amount of antimicrobial expenses and reached 8.23% in the first three quarters of 2015. Since 2013, imipenem / cilastatin sodium has been in the second place. In 2015, the proportion of DDDs reached 4.93% in the first three quarters. Levofloxacin and cefuroxime occupied the first two places in each year and continued to increase. In the first three quarters of 2015, the percentages were 9.04% and 5.91, respectively. . The smallest was carbapenem and other 尾 -lactam drugs (Atreonam 0.39). Conclusion A series of antimicrobial management policies were implemented. The number and frequency of antimicrobial agents were controlled by medical institutions, but the amount of money was weak. Cephalosporins were the most commonly used antibiotics in tertiary hospitals. Increased use of restricted and special-use antibiotics increased the burden on patients.
【作者单位】：山东大学医药卫生管理学院卫生部卫生经济与政策研究重点实验室健康领域社会风险预测治理协同创新中心;国家卫生计生委医院管理研究所;
【基金】：国家自然科学基金(71373147)
【分类号】：R95
【正文快照】： 抗菌药物是临床用药中应用范围最广、品种最多、消耗量最大的一类药物,包括抗生素类、合成抗菌药物和抗真菌药等[1]。近年来,由于世界各地抗菌药物不合理使用,细菌耐药性在全球范围内都有所增长。据世界卫生组织(World Health Organiza-tion,WHO)在2014年发布的全球114个国家

【相似文献】