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湖北省某市6个基层医疗卫生机构门诊处方用药情况分析
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| 篇名： | 湖北省某市6个基层医疗卫生机构门诊处方用药情况分析 |
| TITLE： | |
| 摘要： | 目的：基于基本药物制度实施成熟背景下，调查湖北省某市基层医疗卫生机构门诊处方用药情况，为指导基层医疗卫生机构合理用药提供参考。方法：采用随机数字表法，选取湖北省某市6个基层医疗卫生机构（2个社区卫生服务中心和4个乡镇卫生院），从医院信息系统中导出2014年1月－2016年12月的门诊处方，采用世界卫生组织（WHO）与国际合理用药网络（INRUD）共同开发的处方指标体系分析用药情况。结果：2014－2016年，社区卫生服务中心和乡镇卫生院单张处方平均药品数均逐年下降，社区卫生服务中心分别为2.67、2.57、2.33种/张，乡镇卫生院分别为5.05、4.84、3.59种/张；在单张处方药品平均费用上，社区卫生服务中心逐年下降，分别为57.54、55.27、36.36元/张，乡镇卫生院逐年增加，分别为36.80、37.87、52.13元/张；在基本药物使用比例上，社区卫生服务中心分别为94.44％、90.32％、97.22％，乡镇卫生院分别为89.40％、91.25％、97.22％，均已接近WHO推荐标准；在抗菌药物使用上，社区卫生服务中心的抗菌药物处方率分别为49.42％、47.58％、45.46％，乡镇卫生院的抗菌药物处方率分别为41.90％、39.77％、43.46％，均超过WHO推荐标准；在激素使用上，社区卫生服务中心的激素处方率分别为6.38％、5.75％、5.17％，均在WHO推荐标准范围内，而乡镇卫生院的激素处方率分别为12.71％、9.90％、9.46％，已趋于WHO推荐标准范围内；此外，基层医疗机构处方使用前5位的药品均集中在抗菌药物上。结论：湖北省某市6个基层医疗卫生机构的门诊处方趋于合理，但仍存在抗菌药物使用过多的情况，尤其是乡镇卫生院需要进一步加强管理和监督。 |
| ABSTRACT： | OBJECTIVE： To investigate the status quo of drug use of outpatient prescriptions in primary medical institutions in a city of Hubei province based on the background of the implementation of Essential Medicine System， and to provide reference for rational drug use in primary medical institutions. METHODS： A random number table method was used to select outpatient prescriptions from hospital information system of 6 primary medical institutions （2 community health service centers and 4 township health centers） in a city of Hubei province during Jan. 2014-Dec. 2016. The situation of drug use was analyzed by using prescription index system jointly developed by WHO and INRUD. RESULTS： In 2014-2016， the average number of drugs in each prescription was decreased significantly in community health service centers and township health centers. There were 2.67， 2.57 and 2.33 species/pieces in community health service centers， and 5.05， 4.84 and 3.59 species/pieces in township health centers. The drug cost of each prescription were decreased in community health service centers year by year， being 57.54， 55.27 and 36.36 yuan/piece； those of township health centers were increased year by year， being 36.80， 37.87 and 52.13 yuan/piece， respectively. The proportions of prescription essential medicine were 94.44％， 90.32％， 97.22％ in community health service centers； those of township health centers were 89.40％， 91.25％， 97.22％， which were all close to the standard recommended by WHO. The proportions of antibiotics prescription were 49.42％， 47.58％ and 45.46％ in community health service centers； those of township health centers were 41.90％， 39.77％ and 43.46％， which were all higher than the standard recommended by WHO. The proportions of hormone prescription were 6.38％， 5.75％ and 5.17％ in community health service centers， which were within the standard recommended by WHO； those of township health centers were 12.71％， 9.90％ and 9.46％， which would tend to the standard recommended by WHO. In addition， top 5 drugs were all antibacterial drugs in primary medical institutions. CONCLUSIONS： The outpatient prescriptions are reasonable in 6 primary medical institutions of a city in Hubei province. However， there still is excessive use of antibacterial drugs； township health centers need further supervision and management in particularly. |
| 期刊： | 2018年第29卷第17期 |
| 作者： | 张洁铭，王亚楠，李琛，蔡毅，王文杰，崔丹，毛宗福 |
| AUTHORS： | ZHANG Jieming，WANG Yanan，LI Chen，CAI Yi，WANG Wenjie，CUI Dan，MAO Zongfu |
| 关键字： | 基层医疗卫生机构；门诊处方；合理用药；湖北省 |
| KEYWORDS： | Primary medical institutions； Outpatient prescriptions； Rational drug use； Hubei province |
| 阅读数： | 316 次 |
| 本月下载数： | 8 次 |
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