银川市基层医疗机构抗菌药物使用情况对比分析

Comparative analysis of antimicrobial drug use in primary medical institutions in Yinchuan

目的对比分析银川市不同类型基层医疗机构抗菌药物使用情况,为加强基层医疗机构抗菌药物临床合理使用及有效监管提供参考依据。方法采用分层随机抽样法对银川市6个市、县(区)109家基层医疗机构2017年1-6月门诊处方抗菌药物的使用情况进行分析。结果诊所、社区卫生服务站、乡镇卫生院、村卫生室抗菌药物使用率分别为67.14%、30.67%、17.41%、18.60%,差异有统计学意义(P<0.05);诊所、乡镇卫生院、社区卫生服务站、村卫生室抗菌药物联用处方比例分别为25.41%、13.28%、9.53%、1.62%,差异有统计学意义(P<0.05)。诊所、社区卫生服务站、乡镇卫生院、村卫生室越级处方构成比分别为37.73%、2.40%、7.69%、6.26%,差异有统计学意义(P<0.05);无指征用药处方构成比分别为65.99%、82.60%、79.75%、84.36%,差异有统计学意义(P<0.05)。结论银川市诊所抗菌药物使用率、联用率及越级使用率均高于其他三类基层医疗机构,4类基层医疗机构抗菌药物无指征用药现象普遍存在,应加强基层医疗机构抗菌药物使用监管,尤其对诊所抗菌药物使用进行重点监管,规范基层医疗机构抗菌药物合理使用。

Objective To compare and analyze the usage of antibacterial drugs in different types of primary medical institutions in Yinchuan,it provides a reference for strengthening the rational usage and effective supervision of antibacterial drugs in the primary medical institutions.Methods A stratified random sampling method was used to analyze the usage of antibacterial drugs prescribed by the outpatient department of the 109 primary medical institutions in 6 districts of Yinchuan from January to June 2017.Results The rates of antibacterial drugs usage in the clinics,community health service stations,township health centers and village health clinics were 67.14%,30.67%,17.41%and 18.60%respectively,and the difference was statistically significant(P<0.05);There were 25.41%,13.28%,9.53%and 1.62%prescriptions for the combined use of antibacterial drugs in the clinics,township health centers,community health service stations and village health clinics,with statistically significant differences(P<0.05);The rates of overstep antibacterial drugs prescriptions in clinics,community health service stations,township health centers and village health clinics were 37.73%,2.40%,7.69%and 6.26%,with statistically significant differences(P<0.05);The rates of antibacterial drugs prescriptions without medication indications were 65.99%,82.60%,79.75%and 84.36%,with statistically significant differences(P<0.05).Conclusion The rate of antibacterial drugs usage,combined usage and overstep usage in clinics was higher than the other three kinds of primary medical institutions in Yinchuan.The antibacterial drugs prescriptions without medication indications in the four primary medical institutions were common.We should strengthen the supervision of antibacterial drugs usage in the primary medical institutions,especially in clinics,and standardize the rational usage of antibacterial drugs in the primary medical institutions.