儿童医院实施门诊静脉输液限制管理的效果分析

Effect of Outpatient Infusion Restriction Management in Children′s Hospital

目的:分析儿童医院实施门诊输液限制管理后的效果。方法:将自2016年12月以来实施门诊输液限制管理的某三甲儿童医院作为试行医院,另外选取一家未实施儿童门诊输液限制管理且基础信息可比、就诊人群相接近的医院作为对照医院,采用横断面调查和动态上报收集医院数据。实施儿童门诊输液限制管理2年后,纵向比较试行医院实施输液限制管理前后门诊输液比、就诊人次数和人次平均费用变化;横向比较门诊输液比、人次平均费用和抗菌药物使用情况。结果:实施门诊静脉输液限制管理2年以来,试行医院输液比逐年降低,门诊就诊人次逐年增加,门诊人次平均费用有一定程度的降低。横向比较发现,试行医院输液比、门诊人次平均费用和门诊抗菌药物使用比例均低于对照医院,且差异均有统计学意义(P<0.001)。结论:实施儿童门诊静脉输液限制管理2年取得了初步效果:门诊静脉输液比和门诊抗菌药物使用情况得到有效控制,医院就诊人次不降反增,门诊人次平均费用降低。

Objective:To analyze the effect of outpatient infusion restriction management in Children′s Hospital.Methods:Taking a children′s hospital,which has implemented transfusion restriction management in outpatient department since December 2016 as a trial hospital.And selecting a hospital which does not implemented the transfusion restriction management in children′s outpatient clinics,and whose basic information is comparable and the visiting population is close to each other as a control hospital.Cross-sectional investigation and dynamic reporting were used to collect hospital data.2 years later the implementation of transfusion restriction management Longitudinal comparison was made between the number of outpatient infusion patients and the average cost before and after the implementation of infusion restriction management.Horizontal comparison of the ratio of out-patient infusion,the average cost of person-time and the ratio of antibiotics use was made between trial hospitals and control hospitals.Results:The ratio of intravenous infusion in hospitals has decreased year by year.Outpatient visits increased year by year.The average cost of outpatient visits has been reduced to a certain extent.Horizontal comparison showed that the infusion ratio,the average cost of outpatients and the proportion of antibiotics used in outpatients in the trial hospitals were lower than those in the control hospitals,and the differences were statistically significant(P<0.001).Conclusion:The implementation of intravenous infusion restriction management in children′s outpatient department has achieved initial results in the past two years.The ratio of intravenous infusion in outpatient department and the use of antibiotics in outpatient department have been effectively controlled,the number of hospital visits has not decreased but increased,and the average cost of outpatient visits has decreased.