某市基层医疗机构处方合理用药指标分析

Analysis on Rational Drug Use Index of Prescription in Grass-roots Medical Institutions in a City

目的:探讨某市基层医疗机构门诊处方指标的合理性。方法:采用分层随机抽样法,抽取2019—2021年乡镇卫生院9家、社区服务中心7家、县区级医院4家共72000张处方,采用世界卫生组织处方指标体系分析用药指标,对不同年份和不同分层进行比较,并对注射剂处方率和单张处方平均药品费用进行相关系数分析。结果:除单张处方平均药品费用在2019—2021年呈逐年上升趋势外,其余指标均呈逐年下降趋势(P<0.05),2019年单张处方药品品种数高于WHO标准。药品品种数、抗菌药物处方率、注射剂处方率均按照乡镇卫生院、社区卫生服务中心、县区级医院的顺序呈下降趋势、单张处方平均药品费用呈上升趋势(P<0.05);抗菌药物处方率和注射剂处方率均低于WHO推荐标准,乡镇卫生院单张处方药品品种数高于WHO标准。社区卫生服务中心注射剂处方率与单张药品平均药品费用呈弱正相关(R=0.271,P<0.05)。结论:某市各类型基层医疗机构的合理用药情况基本合理,但不同类型医疗机构之间具有显著性差异,降低社区卫生服务中心的注射剂处方率可减少处方药品金额。

Objective:To explore the rationality of outpatient prescription index of grass-roots medical institutions in a city.Methods:Using the stratified random sampling method,a total of 72000 prescriptions were selected from 9 township health centers,7 community service centers and 4 county and district hospitals from 2019 to 2021.The World Health Organization prescription index system was used to analyze the medication indicators,the different years and different layers were compared,and the correlation coeficient between the injection prescription rate and the average drug cost of a single prescription were analyzed.Results:Except that the average drug cost of a single prescription showed an upward trend year by year from 2019 to 2021,other indicators showed a downward trend year by year(P<0.05).The number of varieties of single prescription drugs in 2019 was higher than the WHO standard.The number of drug varieties,the prescription rate of antibiotics and the prescription rate of injections showed a downward trend in the order of township health centers,community health service centers and county and district hospitals,and the average drug cost of a single prescription showed an upward trend(P<0.05).The prescription rate of antibiotics and injection were lower than the WHO recommended standard,and the number of single prescription drugs in township health centers was higher than the WHO standard.There was a weak positive correlation between the prescription rate of injection in community health service center and the average drug cost of a single drug(R=0.271,P<0.05).Conclusion:The rational drug use of various types of grass-roots medical institutions in a city is basically reasonable,but there are significant differences between different types of medical institutions.Reducing the injection prescription rate of community health service center can reduce the amount of prescription drugs.