基于家庭医生制度的抗菌药物社区健康教育及实施效果分析

The Community Health Education of Antibacterial Agents Based on Family Doctor System and Its Implementation Effect

目的探讨基于家庭医生制度开展的抗菌药物社区健康教育及其实施效果。方法选取2012年12月—2014年12月在华漕社区卫生服务中心执业的家庭医师21人。基于家庭医生制度,以家庭医生为服务主体开展抗菌药物社区健康教育工作;比较社区健康教育实施前后中心门诊抗菌药物的使用率、费用率及家庭医师抗菌药物相关工作压力、服务对象依从性得分。结果实施前、后各发放调查问卷21份,回收有效问卷20份,有效回收率为95.23%。社区健康教育实施后门诊抗菌药物使用率〔9.04%(34 744/384 490)比13.87%(52 623/379 395)〕、费用率〔2.59%(757 459.27/29 210 130.21)比4.24%(1 235 961.76/29 126 255.79)〕均低于实施前,差异有统计学意义(χ2值分别为4 405.19、120 353.07,P<0.01);家庭医师抗菌药物相关工作压力〔(12.85±4.06)分比(18.00±2.24)分〕、服务对象依从性总分〔(11.45±3.56)分比(16.25±3.42)分〕亦均低于实施前,差异有统计学意义(t值分别为7.91、5.86,P<0.01)。结论基于家庭医生制度的抗菌药物社区健康教育可有效降低抗菌药物的使用率和费用率、改善家庭医生的工作压力、提高服务对象的依从性。

Objective To explore the community health education of antibacterial agents based on family doctor system and its implementation effect. Methods We enrolled 21 family doctors who conducted medical practice in Huacao Community Health Service Center from December 2012 to December 2014. The community health education of antibacterial agents based on family doctor system and with family doctor as service subjects was carried. Comparison was made in the usage rate and the expense ratio of antibacterial agents in the central outpatient department and the scores of family doctors＇ working pressure relevant to antibacterial agents and the compliance of service objects between before and after the implementation of health education. Results Before and after implementation of the health education,we distributed 21 questionnaires,20 effective questionnaires were returned with an effective returning rate of 95. 23%. The usage rate of antibacterial agents 〔9. 04%（ 34 744 /384 490）vs. 13. 87%（ 52 623 /379 395） 〕 and expense ratio 〔2. 59%（ 757 459. 27 /29 210 130. 21） vs. 4. 24%（ 1 235 961. 76/29 126 255. 79） 〕after the implementation of community health education were lower than those before the implementation（ χ2values were 4 405. 19 and 120 353. 07,P 〈0. 01）. The score of family doctors＇ working pressure relevant to antibacterial agents〔（ 12. 85 ± 4. 06） vs.（ 18. 00 ± 2. 24） 〕and the score of the compliance of service objects 〔（ 11. 45 ± 3. 56） vs.（ 16. 25± 3. 42） 〕after the implementation of community health education were lower than those before the implementation（ t values were7. 91 and 5. 86,P 〈0. 01）. Conclusion Community health education of antibacterial agents based on family doctor system could effectively reduce the usage rate and expense ratio of antibacterial agents,alleviate the working pressure of family doctors and improve the compliance of service subjects.