2014—2019年上海市A区20家区属医疗机构抗菌药物使用情况分析  

Application of Antibiotics in 20 Medical Institutions in District A of Shanghai from 2014 to 2019

作　　者：马聪 王伟[1,2] 付朝伟[1,2] 严非[1,2] MA Cong;WANG Wei;FU Chaowei;YAN Fei(School of Public Health,Fudan University,Shanghai 200032,China;Key Laboratory of Health Technology Assessment of National Health Commission(Fudan University),Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032

出　　处：《中国医院用药评价与分析》2021年第12期1510-1512,1519,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金项目(No.81861138050)。

摘　　要：目的:了解上海市A区(以下简称"该区")区属各级各类医疗机构的抗菌药物使用情况,为区域内相关管理政策的完善提供相关信息。方法:收集2014—2019年该区20家区属医疗机构门诊和住院患者抗菌药物使用率(%)、抗菌药物使用强度[DDDs/(100人·d)]和Ⅰ类切口手术抗菌药物预防性使用率(%)等抗菌药物使用指标进行统计分析,并引入卫生工作人员数、年门诊量、年入院人次数和年份等变量进行面板回归影响因素分析。结果:2014—2019年,该区区属二级医疗机构住院患者抗菌药物使用率和使用强度均呈降低趋势,Ⅰ类切口手术抗菌药物预防性使用率则持续升高;一级医疗机构门诊患者抗菌药物使用率、住院患者抗菌药物使用率和住院患者抗菌药物使用强度均呈降低趋势。此外,年份显著影响一级和二级医疗机构住院患者抗菌药物使用率,但方向有所不同。结论:该区区属医疗机构门诊患者抗菌药物使用率总体情况较好,一级医疗机构住院患者抗菌药物使用率较高,二级医疗机构Ⅰ类切口手术抗菌药物预防性使用率近年来超出国家指南要求,二级医疗机构住院患者抗菌药物使用率显著降低。OBJECTIVE: To investigate the application of antibiotics in various medical institutions at all levels in district A of Shanghai( hereinafter referred to as “this district”),so as to provide information for the improvement of relevant management policies in this district. METHODS: The application rate of antibiotics( %),application intensity of antibiotics[DDDs/( 100 persons·d) ]and prophylactic application rate of antibiotics in type I incision surgery( %)of outpatients and inpatients in 20 medical institutions from 2014 to 2019 were collected and analyzed statistically.Meanwhile,variables such as the number of medical staff,annual outpatient visits,annual hospital admissions and year were introduced for panel regression analysis. RESULTS: From 2014 to 2019,the application rate and application intensity of antibiotics in inpatients of secondary medical institutions showed the decreasing trend, while the prophylactic application rate of antibiotics in type I incision surgery was in the increasing trend. The application rate of antibiotics in outpatients,inpatients and application intensity in inpatients in primary medical institutions showed the decreasing trend. In addition,the year significantly affected the application of antibiotics in inpatients of primary and secondary medical institutions,yet in different directions. CONCLUSIONS: The overall application rate of antibiotics in outpatients is basically rational. Yet the application rate of antibiotics in inpatients of primary medical institutions is relatively high. In recent years,the prophylactic application rate of antibiotics for type I incision surgery in secondary medical institutions has exceeded the requirements of national guidelines,and the application rate of antibiotics for inpatients in secondary medical institutions has decreased significantly.

关 键 词：抗菌药物 使用状况 医疗机构 分析 

分 类 号：R978.1[医药卫生—药品]