妇幼专科医院抗菌药物使用强度测算模型构建及管控实证分析

Construction of AUD calculating model in maternal and child specialty hospitals and control empirical analysis

  • 摘要: 目的 构建抗菌药物使用强度(AUD)目标值测算模型,科学制定全院及各科室目标值,并借助PDSA(Plan-Do-Study-Act))探索有效促进抗菌药物合理使用的管控机制。方法 结合宁夏医科大学附属银川市妇幼保健院住院患者抗菌药物使用关键指标,构建AUD目标值测算模型。2022、2023年实际值及目标值为对照组1,2024年使用测算模型获取目标值与实际值为实验组1; 2024年7月引入PDSA循环管理,截至2025年6月获取实际值为实验组2,2023年7月-2024年6月实际值为对照组2,分析模型可靠性及管控效果。结果 2024年全年AUD 30.57,同比下降10.93%,降幅差异具有统计学意义(P<0.05),且目标值与实际值SE=2.332,r=0.984,具有相关性(P<0.001)。实验组2每季度AUD实际值均低于对照组2同期,其中第一、四季度同比差异具有统计学意义(P<0.05)。结论 本研究构建的AUD目标值测算模型能够辅助科学设定全院及各科室目标值,可有效实现抗菌药物的前瞻性精细管理,为妇幼专科医院抗菌药物目标值设定提供方法参考,结合PDSA循环管理可进一步压实问题导向的管控模式。但目标值的设定需要综合科室及医院年度发展需求、管控力度等因素,并预见性设计权重纳入目标值测算模型,提高目标管理的实践价值。

     

    Abstract: OBJECTIVE To construct a target value calculating model for antibiotics use density (AUD), scientifically set the target value for the whole hospital and each department and explore the control mechanism that effectively promotes the rational use of antimicrobial drugs with the help of PDSA (Plan-Do-Study-Act). METHODS The target value calculating model was constructed in combination with the key indicators of use of antibiotics among the patients who were hospitalized in Yinchuan Maternal and Child Health Hospital Affiliated to Ningxia Medical University. The actual value and target value of 2022 and 2023 were used as the control group 1, and the target value and actual value that were obtained by calculating model in 2024 were set as th the experimental group 1. PDSA cycle management was introduced in Jul. 2024, and the actual value that was obtained by the end of Jun. 2025 was set as the experimental group 2, and the actual value from Jul. 2023 to Jun 2024 was used as the control group 2. The reliability of the model and the control effect were observed. RESULTS The annual AUD was 30.57 in 2024, representing a year-on-year decrease of 10.93%, with the difference in decline being statistically significant (P< 0.05), and there was correlation between the target value and the actual value SE=2.332,r=0.984 (P< 0.001). The actual value of AUD of each quarter were lower in the experimental group 2 than in the control group 2, and there were significant differences in the year-on-year actual value of AUD between the first and fourth quarter (P< 0.05). CONCLUSIONS The AUD target value calculating model that is constructed in the study can assist in scientifically setting target values for the entire hospital and individual departments. It effectively enables the prospective and refined management of antimicrobial drugs, providing references for setting the target values of antimicrobial drugs in specialized maternal and child hospitals. When combined with PDSA cycle management, it can further strengthen a problem-oriented control model. However, setting the target values requires the consideration of factors such as the annual development needs of departments and the hospital, as well as the intensity of control measures. Additionally, proactively designing weightings and incorporate them into the target value calculating model can enhance the practical value of target management.

     

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