山东省某市乡镇卫生院抗菌药物使用量的影响机制研究  

Analysis of Influencing Mechanism of Antibacterial Drug Usage in Township Health Centers in a City of Shandong Province of China

作　　者：王婷 孙铭丽[3] 郑超[1,2] 沈立岩 阴佳[1,2] 孙强 WANG Ting(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,Shandong,250012,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),山东济南250012 [3]诸城市疾病预防控制中心,山东潍坊262299

出　　处：《医学与社会》2023年第10期25-30,共6页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为71774103。

摘　　要：目的:基于组态视角,探究山东省某市乡镇卫生院抗菌药物使用量的影响因素,分析不同因素组合对乡镇卫生院高抗菌药物使用量的作用路径,为促进抗菌药物合理使用提供参考。方法:利用目的抽样,选取山东省某市S县和Y县36家乡镇卫生院作为研究案例,采用模糊集定性比较分析方法探究乡镇卫生院高抗菌药物使用量影响因素间的联动关系。结果:研究发现可能造成山东省某市乡镇卫生院高抗菌药物使用量的组态共4种,可以综合概括为“高处方医师数且无管理规定驱动型”“高住院床位数且无管理规定驱动型”“低教育培训频次驱动型”共3类;其总体一致性为0.986991,总体覆盖率为0.581929。结论:山东省某市乡镇卫生院高抗菌药物使用量的影响因素复杂,存在多条路径可以导致乡镇卫生院高抗菌药物使用量。应制定促进医生合理使用抗菌药物的具体管理规定,并加强抗菌药物合理应用专题培训频次,促进抗菌药物合理应用。Objective:To explore the influencing factors of antibacterial drug usage in township health centers in a city of Shandong province from the configuration perspective,to analyze the action paths of different factor combinations on the high antibacterial drug usage in township health centers,so as to provide a reference for promoting the rational use of antibacterial drugs.Methods:36 township health centers in S and Y counties of a city in Shandong province were selected as the study cases by purposive sampling.Fuzzy-set qualitative comparative analysis was applied to explore the linkage relationship between the influencing factors of high antibacterial drug usage in township health centers.Results:There were four paths driving the high level of antibacterial drugs usage in township hospitals in a city of Shandong province,which could be summarized as"high number of prescribers and no regulation-driven""high number of inpatient beds and no regulation-driven"and"low frequency of education and training-driven".The overall consistency was 0.986991 and the overall coverage rate was 0.581929.Conclusion:The factors influencing high antibacterial drug usage are complex and there are multiple paths that can lead to high antimicrobial drug usage in township centers in a city of Shandong province.It is necessary to formulate management regulations to promote doctors'rational use of antibacterial drugs,strengthen the frequency of special training and promote the rational use of antibacterial drugs.

关 键 词：乡镇卫生院 合理用药 抗菌药物 山东 

分 类 号：R197.1[医药卫生—卫生事业管理]