基于“互联网+医院-社区”三元联动的深圳市社区健康服务中心集中处方点评干预模式效果分析

The Intervention Effect of Centralized Prescription Reviews Model of Shenzhen Community Health Service Centers Based on the Three-way Linkage of"Internet+Hospital-Community"

目的:探索构建基于“互联网+医院-社区”三元联动的深圳市社区健康服务中心集中处方点评干预模式,并评价其效果,为促进社区合理用药提供参考。方法:按“互联网+医院-社区”集中处方点评干预模式,由医疗卫生服务联合体内上级医院临床药师对深圳市福田区10家社区健康服务中心处方进行1年点评干预,对干预前后点评结果进行统计分析。结果:抗菌药物使用率从干预前的7.65%下降至2.93%,差异有统计学意义(P<0.01);平均处方金额从94.17元下降至80.72元,差异有统计学意义(P<0.05);处方合理率由87.40%提高至95.60%,不适宜处方百分比由12.20%下降至4.30%,差异均有高度统计学意义(P<0.01);基本药物使用金额占比从干预前的51.20%提高到干预后52.04%。结论:实施“互联网+医院-社区”的社区健康服务中心集中处方点评干预模式,对处方各项核心指标的持续改进效果显著,对于促进社区医疗机构合理用药具有积极意义。

Objective:To explore the construction of a centralized prescription review intervention model for Shenzhen community health service centers based on the three-way linkage of"Internet+hospital-community",and evaluate its effect to provide reference for promoting rational drug use in the community.Methods:According to the centralized prescription comment intervention mode of"Internet+hospital-community",the prescriptions of 10 community health service centers in Futian district of Shenzhen city was reviewed and interfered with by clinical pharmacists in superior hospitals within the medical union for 1 year,and the results of comments before and after intervention were statistically analyzed.Results:The usage rate of antibiotics decreased from 7.65% before the intervention to 2.93%,and the diference was statistically significant(P<0.01).The average amount of prescriptions decreased from RMB 94.17 yuan to RMB 80.72 yuan,and the difference was statistically significant(P<0.05).the rational rate of prescription increased from 87.40% to 95.60%,The percentage of inappropriate prescriptions dropped from 12.20%to 4.30%,and the difference was highly statistically significant(P<0.05).The proportion of money used for essential drug increased from 51.20% before intervention to 52.04%after intervention.Conclusion:The implementation of the centralized prescription review intervention model of"Internet+hospital-community"in community health service centers has a significant effect on the continuous improvement of various core indicators of prescriptions.It has positive significance for improving rational drug use in community medical institutions.