基于中断时间序列模型的住院医嘱用药管理效果分析

Analysis of the medication management effect of inpatient medical orders based on interrupted time-series model

目的:研究加强住院医嘱用药管理对住院用药合理性的干预效果。方法:收集天津医科大学肿瘤医院2018年1月至2019年12月住院医嘱用药合格率信息,以2018年12月医院制定重点监控药品目录、设置重点药品管理权限、开展重点药品专项点评等加强住院医嘱用药系列管理办法为干预措施,采用中断时间序列(interrupted time-series)设计模型对加强住院医嘱用药管理效果进行分析。结果:加强住院医嘱用药管理前,住院医嘱用药合格率呈略下降趋势,加强住院医嘱用药管理后,住院医嘱用药合格率呈明显上升趋势,每月提升0.12百分点,比管理前每月调增了0.15百分点,住院医嘱用药合格率由2018年1月的95.40%提升至2019年12月的98.83%。结论:加强住院医嘱用药管理对住院合理用药水平有显著的提升效果。

OBJECTIVE To study the intervention effect of strengthening the management of inpatient prescribed medication on the rationality of inpatient medication.METHODS The information of the pass rate of inpatient doctor’s orders was collected from a hospital in Tianjin from January 2018 to December 2019.In December 2018,the hospital formulated a list of key monitoring drugs,set key drug management authority,and carried out special reviews on the key drugs to strengthen the series management of inpatient doctor’s orders.The method was an intervention measure,and an Interrupted Time-Series design model was used to analyze the effect of strengthening the management of inpatient doctor’s orders for medication.RESULTS Before strengthening the management of inpatient medical orders,the qualified rate of inpatient medical orders showed a slightly downward trend.After strengthening the management of inpatient medical orders,the qualified rate of inpatient medical orders showed a significant upward trend,with a monthly increase of 0.12 percentage points,which was 0.15 percentage points higher than that before the management.The qualified rate of inpatient medical orders increased from 95.40%in January 2018 to 98.83%in December 2019.CONCLUSION Strengthening the management of inpatient doctor’s orders for medication has a significant effect on improving the level of rational drug use in the hospital.