基于控制论对我国临床合理用药的研究

Study on Clinical Rational Drug Use in China Based on Cybernetics

目的:为促进我国医疗机构临床合理用药水平的提高提供参考。方法:在控制论的理论指导下,从药品使用系统层面,就施控子系统、受控子系统及系统内信息3个方面分析阻碍我国临床合理用药的因素。结果与结论:药品使用系统内,阻碍临床合理用药水平提高的诸因素是相互联系的。施控子系统方面的阻碍因素包括缺乏统一的指导文件、控制总目标不全面、控制分目标不明确等;受控子系统方面的阻碍因素来自医疗机构、患者、医疗保险机构3方面;药品使用系统内的信息方面的阻碍因素包括药品信息不足、信息分布不均等。施控子系统应该通过建立和完善国家药物政策,设立控制分目标;重视并加强教育;促进提供全面和可靠的药品信息;建立健全监督和激励机制等方式,全面提高我国临床合理用药水平。

OBJECTIVE： To provide references for the improvement of the clinical rational use of drugs in medical institution in China.METHODS： Under the guidance of the cybernetics,the obstacles factors of clinical rational use of drugs were analyzed from drug use systems,i.e.controlling subsystems,controlled subsystems and system information.RESULTSCONCLUSIONS： In the drug use system,the obstacles that prevent the rational use of drugs are interrelated.The obstacles factors of controlling subsystem were absence of uniform guidance documents,incomplete total porpose control,indefinit subgoal control;those of controlled subsystem were from medical institution,patient and medical insurance institution;those of system information were insufficient drug information and unbalance of information distribution,etc.The controlling subsystem should promote the clinical rational use of drugs through establishing and improving national drug policy,establishing the control subtargets,strengthening and attaching importance to education,facilitating the provision of comprehensive and reliable drug information,establishing and improving the supervision and incentives mechanism,etc.