DRG和临床路径协调发展对抗菌药物使用强度的影响研究  

Study on the Effect of DRG and Clinical Pathway on the Coordinated Development of Antibiotics Use Density

作　　者：田帝 周典[2] 周苑 张钰 吕曼辰 薛同斌 吴烨 Tian Di;Zhou Dian;Zhou Yuan(The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230022,China;不详)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230022 [2]安徽医科大学第二附属医院,安徽合肥230601 [3]安徽医科大学卫生管理学院,安徽合肥230032

出　　处：《中国医院管理》2025年第1期11-15,共5页Chinese Hospital Management

基　　金：国家卫生健康委医院管理所研究项目(YLZLXZ22K001);安徽省重点研发计划高新领域项目(202304a05020071);安徽省卫生健康科研项目(AHWJ2023A30040);安徽省高等学校科学研究项目(2022AH040158,2024AH052615)。

摘　　要：目的 探究疾病诊断相关分组(DRG)和临床路径二者耦合协调发展水平对抗菌药物使用强度的影响关系。方法 选取某三级甲等综合医院2021—2022年7个临床科室数据,采用描述性统计整理数据,应用耦合协调度模型测算DRG和临床路径协调发展水平,以次均药品费用、患者平均住院日为门限变量,运用门限回归模型测算协调发展水平对抗菌药物使用强度的门限值。结果 次均药品费用存在单一门限值,门限值为6 334.69(F=21.98,P<0.05);患者平均住院日存在双重门限值,门限值分别为6.74和8.20 (F=160.53、15.99,P<0.1)。两门限变量中协调发展水平与抗菌药物使用强度间的统计值均为正数。结论 DRG和临床路径协调发展水平对抗菌药物使用强度为非线性关系,且在各门限变量区间内均呈大小不同的正向促进作用。医疗机构应重视非线性关系,善用医院信息与询证管理手段,基于精准的监测与分析开展抗菌药物管理。Objective To explore the influence of the coupling and coordination of DRG and clinical pathways on Antibiotics Use Density.Methods The data of 7 clinical departments in a sample hospital from 2021 to 2022 were selected,the data were collated through descriptive statistics,and the coupling coordination degree model was used to measure the coordinated development level of DRG and clinical pathways.Taking the per-average drug cost and the average hospital stay of patients as the threshold variables,the threshold regression model was used to calculate the threshold value of Antibiotics Use Density at the level of coordinated development.Results There was a single threshold(F=21.98,P<0.05)of 6334.69 and a double threshold(F=160.53,15.99,P<0.1)of 6.74 and 8.20 for the average length of stay of patients.The statistical values between the level of coordinated development and Antibiotics Use Density in the two threshold variables were positive.Conclusion There is a nonlinear relationship between the level of coordinated development of DRG and clinical pathway with Antibiotics Use Density,and there is a positive promotion effect,and there are differences in the impact size in different threshold variable intervals.Medical institutions should pay attention to the nonlinear relationship,make good use of hospital informatization,do a good job in reasonable monitoring,and reasonably promote the management of antimicrobial drugs.

关 键 词：疾病诊断相关分组 临床路径 抗菌药物使用强度 门限回归模型 耦合协调度 

分 类 号：R197.3[医药卫生—卫生事业管理]