DIP模式下轮替治疗管控抗菌药物使用强度的有效性分析  

Effectiveness Analysis of Antibiotic Rotation Therapy in Controlling the Antibiotics Use Density in the DIP Mode

作　　者：宫丽 陈金元 叶程龙 徐宏 GONG Li;CHEN Jinyuan;YE Chenglong;XU Hong(Longhua District People's Hospital of Shenzhen,Shenzhen,Guangdong,China 518109)

机构地区：[1]广东省深圳市龙华区人民医院,广东深圳518109

出　　处：《中国药业》2024年第23期32-35,共4页China Pharmaceuticals

基　　金：广东省深圳市龙华区医疗卫生机构区级科研项目[2021103]。

摘　　要：目的探讨区域点数法总额预算和按病种分值付费(DIP)模式下抗菌药物轮替治疗管控抗菌药物使用强度(AUD)的有效性。方法回顾性分析医院2022年1月至2023年6月收治的1138例阑尾炎术后患者的临床资料,以2022年1月至8月(DIP模式下抗菌药物轮替前)入院的患者为A组(596例),以2022年9月至2023年6月(DIP模式下抗菌药物轮替后)入院的患者为B组(542例),对比两组患者的临床疗效、白细胞(WBC)、血清淀粉样蛋白(SAA)、白细胞介素6(IL-6)、肠鸣音恢复时间、排气时间、排便时间、术后不良事件发生率、抗菌药物累计限定日剂量(DDD)、抗菌药物用药构成、抗菌药物累计输液袋数、抗菌药物花费、AUD。结果两组患者的临床疗效、WBC、SAA、IL-6、肠鸣音恢复时间、排气时间、排便时间及术后不良事件发生率均无显著差异(P>0.05),B组患者的抗菌药物累计DDD、抗菌药物单独用药率、抗菌药物累计输液袋数、抗菌药物花费、AUD均显著优于A组(P<0.05)。结论基于DIP模式的抗菌药物轮替在不影响整体疗效的前提下对AUD有一定管控效果,且能减少患者的治疗花费和医疗垃圾产出。Objective To investigate the effectiveness of antibiotic rotation therapy in controlling the antibiotics use density(AUD)in the diffuse panbronchiolitis(DIP)mode.Methods A retrospective analysis was conducted on the clinical data of 1138 patients underwent operation for appendicitis admitted to the hospital from January 2022 to June 2023.Patients admitted from January to August 2022(before antibiotic rotation in DIP mode)were selected as the group A(596 cases),and patients admitted from September 2022 to June 2023(after antibiotic rotation in DIP mode)were selected as the group B(542 cases).The clinical efficacy,white blood cell count(WBC),serum amyloid A protein(SAA),interleukin-6(IL-6),recovery time of bowel sound,exhaust time,defecation time,incidence of postoperative adverse events,cumulative defined daily dose(DDD)of antibiotics,composition of antibiotics use,cumulative number of infusion bags of antibiotics,cost of antibiotics,and AUD were compared between the two groups.Results There was no significant difference in clinical efficacy,WBC,SAA,IL-6,the recovery time of bowel sound,exhaust time,defecation time,and incidence of postoperative adverse events between the two groups(P>0.05).The cumulative DDD of antibiotics,use rate of antibiotics alone,cumulative number of infusion bags of antibiotics,antibiotic cost,and AUD in the group B were significantly better than those in the group A(P<0.05).Conclusion Antibiotic rotation based on DIP mode has a certain control effect on the AUD without affecting overall efficacy,and can reduce the cost of patients and the output of medical waste.

关 键 词：区域点数法总额预算和按病种分值付费模式 抗菌药物轮替 抗菌药物使用强度 有效性 

分 类 号：R95[医药卫生—药学]