医院等级评审对新农合患者Ⅰ类切口预防应用抗菌药物的影响

Impact of Hospital Grade Assessment to Antibiotics Prophylaxis in Type Ⅰ Incision Surgery under New Rural Cooperative Medical System

目的评价医院等级评审对新农合患者Ⅰ类切口预防应用抗菌药物的影响。方法分别抽取不同时间段新农合患者Ⅰ类手术切口病历204份（2012-01~04）和193份（2013-05~2014-06）作为评审前后数据资料,对比分析医院等级评审对新农合患者Ⅰ类切口预防应用抗菌药物的影响。结果医院等级评审后,本院新农合患者Ⅰ类切口预防使用抗菌药物情况较评审前得到明显改善。抗菌药物使用率由评审前100%降至45.08%,抗菌药物联用比例由53.92%降为0,给药时机合理率由61.76%上升至93.10%,给药指征合理率由70.10%上升至94.25%,药物选择合理率由71.08%上升至93.10%,使用疗程合理率由62.75%上升至88.50%,具有显著性统计学意义（P〈0.05）。结论医院等级评审加强医院抗菌药物应用的管理,规范新型农村合作医疗的合理用药。

OBJECTIVE To evaluate the impact of hospital grade assessment on antibiotics prophylaxis in type Ⅰ incision surgery under the New Rural Cooperative Medical System. METHODS To extract the different time period medicine records which underwent type I incision surgery under the New Rural Cooperative Medical System. 204 medical records（ January 2012-April 2013） was before hospital grade assessment and 193 medical records（ May 2013-June 2014） was after hospital grade assessment were compared. The impact of hospital grade assessment to antibiotics prophylaxis in type Ⅰ incision surgery under the New Rural Cooperative Medical System was analyzed. RESULTS After hospital grade assessment,the antibiotics prophylaxis for type Ⅰ incision surgery under the New Rural Cooperative Medical System has been obviously improved than hospital grade before the review. The usage of antimicrobial drugs was from 100% to 45. 08%,the antibacterial drug combination was reduced from 53. 92% to 0,the reasonable rate of delivery time increased from 61. 75% to 93. 10%,the reasonable rate of drug indication increased from 70. 10% to 94. 25%,the reasonable rate for the choice of the drug increased from 71. 08% to 93. 10%,the reasonable rate of treatment course increased from 62. 75% to 88. 50%.There is significant difference between the 2 groups（ P〈0.05）. CONCLUSION Hospital grade assessment is beneficial to standardize the application of antimicrobial drugs,and can improve the rational drug application under the New Rural Cooperative Medical System.