某市临床不合理用药及医学检查现状及对策

Present Situation and Countermeasures on Unreasonable Clinical Medication and Medical Examinations in One City

目的了解临床不合理用药及医学检查现状,探究有针对性的解决办法。方法抽查自贡市2007年1月～2008年6月共8家二级甲等以上综合或专科医院出院归档病历1480份,按统一方法和标准对临床医学检查、用药是否合理进行评价。结果不合理用药为28.65%。其中,不合理应用抗菌药物占70.99%,主要表现为选药档次高、给药次数及疗程不合理、联合用药不合理、无指征用药等;不合理医学检查为17.50%,主要表现为过度医学检查、检验及重复检查等。结论临床执业医师是不合理医疗的主要责任者。医疗机构要从根本上解决不合理医疗问题,重点应加强执业医师业务技术培训及职业道德教育。

Objective To understand the present situation of unreasonable clinical medication and medical examinations and to obtain an effective solution. Method Spot - checks was done on 1480 pieces of medical records, filed up from January, 2007 to June, 2008 in eight hospitals of 2 - grade - A - class level （ both general and special hospitals are involved ） in Zigong city, to examine whether their clinical medication and medical examinations were reasonable with a unified method, according to the standard for clinical medicine inspection. Result Unreasonable medication （ mainly resulted from unreasonable use of upper - scale medicine, unreasonable suggested dosage and course of treatment, incorrect joint - use of medicine, medication with no morbid indication etc. ） rate was 28.65% , of which the unreasonable prescription of antibiotics accounted for 70.99%. The un- reasonable medical examinations took up 17.50%. Excessive medical check - up and tests, repeatedly examinations etc. were to blame for the high percentage. Conclusion Clinicians and doctors must bear enough responsibility for the consequences. Therefore, in order to change the present situation and get rid of all the unreasonable medical problems fundamentally the medical insti- tutions should not only give sufficient technical training to clinicians, but also need to pay more attention to their moral education.