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基于疾病诊断相关分组的烧伤科抗菌药物精细化管理探索
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| 篇名： | 基于疾病诊断相关分组的烧伤科抗菌药物精细化管理探索 |
| TITLE： | Exploration on fine management of antibiotics in burn department based on disease diagnosis related groups |
| 摘要： | 目的 基于疾病诊断相关分组（DRGs）对我院烧伤科患者抗菌药物的合理应用管理进行探索。方法选取我院烧伤科2020年7月至2021年6月出院的病例为研究对象，获取其DRG数据。筛选病例数大于10的DRG病组对其抗菌药物应用情况进行分析，并对典型病组抗菌药物的应用情况进行横向和纵向评价。结果在我院烧伤科3732例出院病例中，共有3515例病例纳入66个DRG病组，其中21个DRG病组纳入本研究，共涉及12个核心组。在21个DRG病组中，抗菌药物使用强度（AUD）最大的为AH11组[102.20DDDs/（100人·d）]，其抗菌药物使用率为100％，抗菌药物联合使用率为81.82％，病例组合指数（CMI）为11.49；AUD最小的为XR19组[1.01DDDs/（100人·d）]，其抗菌药物使用率为5.06％，抗菌药物联合使用率为0，CMI为0.81。同一核心组组内比较发现，其AUD随着CMI的升高而升高。对WB11组进行横向比较分析发现，不同医师间AUD的差距较大；对其进行纵向比较发现，WB11组AUD随时间的变化相对较小。结论基于DRGs对抗菌药物进行横向和纵向评价，可为抗菌药物管控提供新的线索，有助于实现抗菌药物精细化专科管理。 |
| ABSTRACT： | OBJE CTIVE To explore the rational application and management of antibiotics in burn department of our hospital based on disease diagnosis related groups （DRGs）. METHODS Patients discharged from the burn department of our hospital from July 2020 to June 2021 were selected as the research objects to collect DRG data. The overall application of antibiotics in DRG group with more than 10 cases were analyzed ，and the application of antibiotics in typical disease groups were evaluated horizontally and vertically. RESULTS Among 3 732 discharged cases in the burn department of our hospital ，a total of 3 515 cases were included in 66 DRG groups ，21 DRG groups of which were included in the study. Among 21 DRG groups ，the maximum antibiotics use density （AUD）of antibiotics was 102.20 DDDs/（100 person·d）in AH 11 group，the utilization ratio of antibiotics was 100％，and the combined use rate of antibiotics was 81.82％；case-mix index （CMI）value was 11.49. The minimum AUD was 1.01 DDDs/（100 person·d）in XR 19 group，the utilization ratio of antibiotics was 5.06％，and the combined use rate of antibiotics was 0；CMI value was 0.81. Within the same core group ，AUD increased with the increase of CMI. The horizontal comparison and analysis of WB 11 group showed that there was a large gap in AUD among different physicians. The vertical comparison of AUD in WB11 group showed relatively small changes over time. CONCLUSIONS The horizontal and vertical evaluation of antibiotics based on DRGs can provide new clues for the control of antibiotics and help to realize the fine specialized management of antibiotics. |
| 期刊： | 2022年第33卷第15期 |
| 作者： | 武华军，陈永刚，涂少辉，赵琳，郭黄鹏，杨秋香 |
| AUTHORS： | WU Huajun，CHEN Yonggang，TU Shaohui，ZHAO Lin，GUO Huangpeng，YANG Qiuxiang |
| 关键字： | 疾病诊断相关分组；抗菌药物；精细化管理；烧伤科；合理用药 |
| KEYWORDS： | disease diagnosis related groups ；antibiotics；fine management ；burn department ；rational drug use |
| 阅读数： | 268 次 |
| 本月下载数： | 12 次 |
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