2017-2019年中国基层医疗机构处方用药分析  

Analysis of Drug Utilization in Prescriptions of Primary Healthcare Facilities in China from 2017 to 2019

作　　者：张宇晴 巩志文 余俊璇 李灿[1] 朱玥桢 于爱晨 范平安 胡琳 王芳 傅孟元 管晓东[1,2] 史录文[1,2] ZHANG Yuqing;GONG Zhiwen;YU Junxuan;LI Can;ZHU Yuezhen;YU Aichen;FAN Ping'an;HU Lin;WANG Fang;FU Mengyuan;GUAN Xiaodong;SHI Luwen(Department of Pharmacy Administration and Clinical Pharmacy,School of Pharmaceutical Sciences,Peking University,Beijing,100191,China;不详)

机构地区：[1]北京大学药学院药事管理与临床药学系,北京100191 [2]北京大学医药管理国际研究中心,北京100191 [3]北京市东城区社区卫生服务管理中心,北京100010

出　　处：《中国社会医学杂志》2024年第3期350-354,共5页Chinese Journal of Social Medicine

基　　金：国家卫健委委托课题项目(基本药物制度背景下基层医疗机构合理用药研究)。

摘　　要：目的 分析2017-2019年中国基层医疗机构的处方用药现状,为进一步改善我国基层医疗机构合理用药提供依据。方法 通过二阶段结构性抽样方法设计并实施全国基层医疗机构门诊处方调查。采用WHO/INRUD用药评价指标,应用描述性统计、Wilcoxon秩和检验、卡方检验分析方法,分析基层医疗机构用药现状和变化趋势。结果 研究共纳入2017-2019年6个省、31个地市的269家基层医疗机构的64.2万张门诊处方。处方分析结果显示,2017-2019年,除每处方药物费用呈显著上升趋势外,每处方药品数、抗菌药物处方率、注射剂处方率和激素处方率均呈显著下降趋势;所有抗菌药物处方中包含共计25.6万个抗菌药物,其中82.2%为广谱抗菌药物;城乡间用药指标值差异较小。结论 中国基层医疗机构用药整体情况持续改善、城乡差距缩小,但药物使用合理性和抗菌药物种类选择方面仍有待进一步改善。Objective To evaluate the outpatient prescriptions in primary healthcare facilities(PHFs)in China from 2017 to 2019,to provide the evidence for further improvement of rational drug use in China's PHFs.Methods Using a two-stage structural sampling method,a nationwide cross-sectional survey for outpatient prescriptions in PHFs was designed and conducted.Descriptive analysis,wilcoxon rank-sum test and chi-squared test were applied to evaluate the status and trend of drug use with the WHO/INRUD indicators.Results A total of 641732 outpatient prescriptions from 269 PHFs in 6 provinces between 2017 and 2019 were included.The average number of drugs per prescription,and the rate of antibiotics,injection,and corticosteroid prescribing were decreased statistically significantly from 2017 to 2019,whereas the average cost per prescription increased during the study period.All prescriptions contained 256474 antibiotics,of which 82.2%was broad-spectrum.Only slight differences were found between community healthcare centers and rural township hospitals.Conclusion In the past years,drug utilization in China's PHFs has been improved and the disparity between urban and rural areas has been mitigated.Nonetheless,there is still room for further improvement of rational drug use and the appropriate selection of antibiotics.

关 键 词：基层医疗机构 药物使用 处方用药 

分 类 号：R95[医药卫生—药学]