2011–2017年三明市县级公立医院医生药品使用趋势研究

doi:10.5246/jcps.2022.03.020

中国药学(英文版) ›› 2022, Vol. 31 ›› Issue (3): 218-223.DOI: 10.5246/jcps.2022.03.020

• 【药事管理与临床药学专栏】 • 上一篇下一篇

2011–2017年三明市县级公立医院医生药品使用趋势研究

于爱晨¹, 傅孟元¹, 倪冰玉¹, 满春霞², 张婧媛¹, 胡华杰¹, 田野¹, 周越¹, 韩晟³, 管晓东¹^,³^,^*(), 史录文¹^,³

1. 北京大学药学院药事管理与临床药学系, 北京 100191
2. 航天中心医院, 北京 100049
3. 北京大学医药管理国际研究中心, 北京 100191

收稿日期:2020-12-27 修回日期:2021-03-15 接受日期:2021-04-20 出版日期:2022-03-31 发布日期:2022-03-31
通讯作者: 管晓东
作者简介:
+ Tel./Fax: +86-10-82805019, E-mail: guanxiaodong@pku.edu.cn

Trends on medicine use in county public hospitals in Sanming, China from 2011 to 2017

Aichen Yu¹, Mengyuan Fu¹, Bingyu Ni¹, Chunxia Man², Jingyuan Zhang¹, Huajie Hu¹, Ye Tian¹, Yue Zhou¹, Sheng Han³, Xiaodong Guan Guan¹^,³^,^*(), Luwen Shi¹^,³

1 Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 100191, China
2 Aerospace Center Hospital, Beijing 100049, China
3 International Research Center for Medicinal Administration, Peking University, Beijing 100191, China

Received:2020-12-27 Revised:2021-03-15 Accepted:2021-04-20 Online:2022-03-31 Published:2022-03-31
Contact: Xiaodong Guan Guan

摘要/Abstract

摘要：

三明医改备受各方关注, 但探讨三明医改对医生用药行为的研究较少, 本研究旨在对三明市县级公立医院医生药品使用情况进行评价分析。本研究收集三明市9家县级公立医院内科和儿科2011年1月1日至2017年12月31日的门诊处方, 从平均每张处方通用名药品数、抗菌药物使用率、抗菌药物联合使用率、中成药使用率、注射剂使用率和中药注射剂占注射剂比率6个评价指标分析药品使用情况, 采用Mann-Kendall趋势性检验分析变化趋势。处方(n = 1 577 904)抗菌药物使用率和联合使用率2011年为57.5%和12.2%, 2017年降至28.2% (P = 0.007)和2.9% (P = 0.003); 注射剂使用率2011年为30.2%, 2017年降至5.3% (P = 0.003); 内科处方(n = 780 491)和儿科处方(n = 797 413)抗菌药物使用率由2011年的39.3%和71.4%降至2017年的10.2% (P = 0.003)和47.3% (P = 0.035), 抗菌药物联合使用率由2011年的15.9%和9.4%降至2017年的2.9% (P = 0.003)和2.9% (P = 0.016); 注射剂使用率2011年为17.8%和39.6%, 2017年降至1.9% (P = 0.003)和9.0% (P = 0.003)。三明门诊抗菌药物和注射剂使用率下降明显, 提示三明医改一定程度上促进了药品的合理使用。

关键词: 三明医改, 药品使用, 用药行为

Abstract:

Sanming model in healthcare reform has attracted much attention due to its comprehensive and efficient exploration, while its impact on physicians’ prescribing behavior remains unknown. In the present study, we aimed to evaluate the impact of Sanming reform on physicians’ medicine use in county-level public hospitals. We collected outpatient prescriptions in the internal medicine and pediatric departments from nine county public hospitals in Sanming from January 2011 to December 2017. We used six prescribing indicators to analyze physicians’ medicine use. The Mann-Kendall test was used to examine trends in the study outcomes. A total of 1 577 904 outpatient prescriptions were included in this study. The average prescription rate of antibiotics and combined antibiotics were 57.5% and 12.2% in 2011, respectively, which were declined to 28.2% (P = 0.007) and 2.9% (P = 0.003) in 2017, respectively. The average prescription rate of injection was 30.2% in 2011 and declined to 5.3% (P = 0.003) in 2017. As for the subgroup analysis of the internal medicine and pediatric departments, the average prescription rate of antibiotics was 39.3% and 71.4% in 2011, respectively, which was declined to 10.2% (P = 0.003) and 47.3% (P = 0.035) in 2017, respectively. The average prescription rate of combined antibiotics was 15.9% and 9.4% in 2011, respectively, which was declined to 2.9% (P = 0.003) and 2.9% (P = 0.016), respectively. The average prescription rate of injection was 17.8% and 39.6% in 2011, respectively, which was declined to 1.9% (P = 0.003) and 9.0% (P = 0.003), respectively. Our study showed a significant decreasing trend in antibiotic use in county-level public hospitals after the Sanming healthcare reform, indicating that the reform successfully promoted the appropriate use of medicine to some extent.

Key words: Sanming healthcare reform, Medicine use, Prescribing behavior

Supporting:

于爱晨, 傅孟元, 倪冰玉, 满春霞, 张婧媛, 胡华杰, 田野, 周越, 韩晟, 管晓东, 史录文. 2011–2017年三明市县级公立医院医生药品使用趋势研究[J]. 中国药学(英文版), 2022, 31(3): 218-223.

Aichen Yu, Mengyuan Fu, Bingyu Ni, Chunxia Man, Jingyuan Zhang, Huajie Hu, Ye Tian, Yue Zhou, Sheng Han, Xiaodong Guan Guan, Luwen Shi. Trends on medicine use in county public hospitals in Sanming, China from 2011 to 2017[J]. Journal of Chinese Pharmaceutical Sciences, 2022, 31(3): 218-223.

图/表 5

Table 1. Prescribing indicators for drug utilization and descriptions.

Table 2. Total number of prescriptions collected from 2011 to 2017.

Table 3. The trend of prescription indicators.

Table 4. The trends of prescription indicators in the internal medicine department.

Table 5. The trends of prescription indicators in the pediatric department.

参考文献 21

[1]	Yip, W.C.M.; Hsiao, W.C.; Chen, W.; Hu, S.L.; Ma, J.; Maynard, A. Early appraisal of China's huge and complex health-care reforms. Lancet. 2012, 379, 833–842.
[2]	Chen, Z. Launch of the health-care reform plan in China. Lancet. 2009, 373, 1322–1324.
[3]	Klynveld Peat Marwick Goerdeler. Sanming: The Real Story of Grass-roots Healthcare Transformation in China; 2016.
[4]	Ma, J. Discussion on the reform of public hospitals: case study on breakthrough of health reform in Sanming City. Heal. Econ. Res. 2014, 10, 34–36.
[5]	Li, L. Public Hospital Reform Sanming model. Chin. J. News Rep. 2013, 9, 3840.
[6]	Fu, H.Q.; Li, L.; Li, M.Q.; Yang, C.Y.; Hsiao, W. An evaluation of systemic reforms of public hospitals: the Sanming model in China. Health Policy Plan. 2017, 32, 1135–1145.
[7]	He, Y.; Dou, G.; Huang, Q.; Zhang, X.; Ye, Y.; Qian, M.; Ying, X. Does the leading pharmaceutical reform in China really solve the issue of overly expensive healthcare services? Evidence from an empirical study. PLoS One. 2018, 13, e0190320.
[8]	Meng, Z.L.; Zhu, M.; Cai, Y.Y.; Cao, X.H.; Wu, H.Z. Effect of a typical systemic hospital reform on inpatient expenditure for rural population: the Sanming model in China. BMC Heal. Serv. Res. 2019, 19, 231.
[9]	Ghei, P. How to investigate drug use in health facilities. Selected drug use indicators. Heal. Policy. 1995, 34, 73.
[10]	The journal of global antimicrobial resistance meets the World Health Organization (WHO). J. Glob. Antimicrob. Resist. 2019, 18, 305–308.
[11]	Fitchett, J.R.; Atun, R. Antimicrobial resistance: opportunity for Europe to establish global leadership. Lancet Infect. Dis. 2016, 16, 388–389.
[12]	Qiao, M.; Ying, G.G.; Singer, A.C.; Zhu, Y.G. Review of antibiotic resistance in China and its environment. Environ. Int. 2018, 110, 160–172.
[13]	Zhang, Z.T.; Hu, Y.H.; Zou, G.Y.; Lin, M.; Zeng, J.; Deng, S.M.; Zachariah, R.; Walley, J.; Tucker, J.D.; Wei, X.L. Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions. Glob. Heal. Action. 2017, 10, 1287334.
[14]	Li, Y. China’s misuse of antibiotics should be curbed. BMJ. 2014, 348, g1083.
[15]	Holloway, K.A.; Ivanovska, V.; Wagner, A.K.; Vialle-Valentin, C.; Ross-Degnan, D. Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence. Trop. Med. Int. Heal. 2013, 18, 656–664.
[16]	Shankar, P. Medicines use in primary care in developing and transitional countries: fact book summarizing results from studies reported between 1990 and 2006. Bull World Health Organ. 2009, 87, 804.
[17]	World Health Organization. Safety of injections: Global facts and figures. Geneva: World Health Organization. 2004.
[18]	Bairami, F.; Soleymani, F.; Rashidian, A. Improving injectable medicines prescription in outpatient services: a path towards rational use of medicines in Iran. Int. J. Health Policy Manag. 2016, 5, 321–324.
[19]	Li, H.; Wang, S.; Yue, Z.; Ren, X.; Xia, J. Traditional Chinese herbal injection: Current status and future perspectives. Fitoterapia .2018, 129, 249–256.
[20]	Liu, S.; Qiao, Y.; Liu, G.F. Adverse drug reactions of traditional Chinese medicine injections and irrational drug use. Central. South Pharm. 2016, 14, 1177–1182. (in Chinese)
[21]	Principi, N.; Esposito, S. Antibiotic-related adverse events in paediatrics: unique characteristics. Expert. Opin. Drug Saf. 2019, 18, 795–802.

2011–2017年三明市县级公立医院医生药品使用趋势研究

Trends on medicine use in county public hospitals in Sanming, China from 2011 to 2017

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