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基于病例组合指数与秩和比法的抗菌药物使用强度分档评价模型的建立与应用

Establishment and application of evaluation model of antibiotics use density based on CMI and rank-sum ratio

  • 摘要:
    目的 创新性引入相关关键指标计算抗菌药物使用强度(AUD),实现AUD分档评价。
    方法 基于华东地区某三级甲等综合医院2021年1—6月在DIP系统中的病例组合指数(CMI)、抗菌药物使用率以及HIS系统中的AUD数据,确立最优直线回归模型。通过非整秩次方法编秩、计算,对基于CMI调整AUD的秩和比(RSR)分档与AUD单一评估进行的RSR分档进行比较。
    结果 医院32个科室的AUD引入CMI值的秩和比分档评价模型显示,12个科室的分档结果产生变化,占37.5%,需要加强管控科室(分档为下和中级别)的总体数量有所上升;引入CMI指数调整AUD后管控级别上调的科室7个,管控级别下调的科室5个。
    结论 基于CMI与秩和比法的AUD分档评价模型调整各科室AUD指标并实行分层评价的方法可行、有效。

     

    Abstract:
    Objective To achieve refinement management of antibiotics by innovatively introducing relevant key indicators to control antibiotics use density (AUD).
    Methods Based on the data of case mix index (CMI), the utilization rate of antibiotics in DIP system, and AUD in HIS system in a Class Ⅲ Grade A general hospital in East China from January to June 2021, the introduced key indicators were established and the optimal linear regression model was established. The non-integral rank method was used to rank and calculate. Rank-sum ratio (RSR) grading based on CMI adjusted AUD was compared with RSR grading based on AUD single assessment.
    Results The RSR classification of AUD of 32 departments in the hospital was studied by introducing CMI values. It was found that the classification results of 12 departments changed, accounting for 37.5%, and the overall number of departments (classified as lower and middle level) in need of strengthening control increased. After the introduction of CMI to adjust AUD, control level raised in 7 departments and fell in 5 departments.
    Conclusions The grading evaluation model of based on CMI and RSR is effective in the control of AUD in these departments.

     

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