基于病例组合指数校正抗菌药物使用强度的模型拟合研究  

Model fitting study on antimicrobial usage intensity corrected by case mix index

作　　者：张钰 周典[2] 田帝 周苑 吕曼辰 薛同斌 吴烨 周睿[4] ZHANG Yu;ZHOU Dian;TIAN Di;ZHOU Yuan;LV Manchen;XUE Tongbin;WU Ye;ZHOU Rui(School of Health Management,Anhui Medical University,Anhui Province,Hefei,230032,PRC)

机构地区：[1]安徽医科大学卫生管理学院,安徽省合肥市230032 [2]安徽医科大学第二附属医院,安徽省合肥市230601 [3]安徽医科大学第一附属医院,安徽省合肥市230022 [4]安徽医科大学医院管理研究所,安徽省合肥市231602

出　　处：《中国医院》2025年第1期65-68,共4页Chinese Hospitals

基　　金：安徽医科大学医院管理研究所开放项目(2023gYkJ01),安徽医科大学医院管理研究所开放项目(2022gykj06);安徽省科技厅重点研发计划高新领域项目(202304a05020071);安徽省教育厅高校协同创新项目(GXXT-2022-058);安徽省教育厅高等学校科学研究项目(2022AH040158);国家卫生健康委医院管理所研究项目(YLZLXZ22K001)。

摘　　要：目的:探究病例组合指数与抗菌药物使用强度之间的关联关系,并对抗菌药物使用的评价进行调整,对其综合考量。方法:收集安徽省某三甲医院2021-2023年病例组合指数与抗菌药物相关指标,首先通过线性模型、二次曲线等8种模型拟合探索病例组合指数与抗菌药物相关指标之间的关系,随后通过秩和比综合评价法对不同科室间抗菌药物的使用情况重新评价。结果:病例组合指数与抗菌药物使用强度之间关联性较弱,但病例组合指数与同期出院人数的乘积与抗菌药物使用累积数存在较强关联,以此为基础进行的秩和比综合评价结果前后出现较大波动。结论:病例组合指数与抗菌药物使用强度之间存在间接关联,在后续抗菌药物使用的模型运算时应考虑校正,以增强评价结果的真实性。Objective:To explore the association between the case mix index(CMI)and antimicrobial usage intensity(AUD),adjust the evaluation of antimicrobial usage,and provide a comprehensive assessment.Methods:Data on CMI and antimicrobial-related indicators from a Grade III Level A Hospital in Anhui Province from 2021 to 2023 were collected.Eight models,including linear and quadratic curves,were applied to fit the relationship between CMI and antimicrobial indicators.Subsequently,the rank-sum ratio(RSR)method was used to reevaluate antimicrobial usage across different departments.Results:A weak correlation was observed between CMI and AUD.However,a strong correlation was found between the product of CMI and the number of discharges during the same period and the cumulative antimicrobial usage.Comprehensive evaluations using the RSR method showed significant changes before and after adjustment.Conclusion:There is an indirect association between CMI and AUD.Future modeling of antimicrobial usage should include correction factors to enhance the accuracy and reliability of evaluation results.

关 键 词：病例组合指数 抗菌药物使用 模型拟合 秩和比法 

分 类 号：R197[医药卫生—卫生事业管理]