Effectiveness of multi-department collaboration control based on rationality evaluation rule for antibiotics use under DRG
- VernacularTitle:基于DRG的抗菌药物使用合理性评价细则构建及多部门协作管控成效
- Author:
Changlu QIU
1
,
2
;
Hongpeng BI
1
,
2
;
Xuefei DAI
1
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Anhui Medical University，Hefei 230032，China
2. Dept. of Pharmacy，Anhui Public Health Clinical Center，Hefei 230032，China
- Publication Type:Journal Article
- Keywords:
DRG;
multi-department cooperation control;
weighted TOPSIS method;
respiratory system infection/inflammation
- From:
China Pharmacy
2024;35(23):2941-2947
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To promote rational use of antibiotics taking diagnosis related group （DRG） of respiratory system infection/inflammation as a starting point. METHODS The rules for evaluating the rationality of clinical use of antibiotics in patients with respiratory system infection/inflammation were established（including 12 evaluation indicators such as drug selection， centrally procured varieties， usage and dosage）， and the attribute hierarchy model was applied to assign scoring weights to each indicator. A total of 102 cases from January to September 2021 （before multi-department collaboration and control， as control group） and 103 cases from January to September 2022 （after multi-department collaboration and control， as interention group） were comprehensively evaluated by weighted pros and cons method. The relative proximity （C）i between each evaluation index and the optimal scheme was calculated， and the rationality of the use of antibacterial， antibacterial drug related index， health economic evaluation index and diagnosis and treatment outcome index were compared before and after multi-department collaboration control. RESULTS In the use of antibiotics， the irrational rate of antibiotics use， the average cumulative defined daily dose （DDD） and the utilization rate of combined drugs in the intervention group were significantly lower than control group （P＜0.05）. In the indicators of health economic evaluation， the average cost of antibiotics per time and average cost of hospitalization per time in the intervention group were significantly lower than control group （P＜0.05）. In the relevant indicators of diagnosis and treatment outcome， the average hospitalization days of patients in the intervention group were significantly lower than control group （P＜ 0.05）， but the clinical efficacy was not significantly different（P＞0.05）. Further comparison between groups showed that the average cumulative DDD of ES31， ES33 and ES35 patients in the intervention group was significantly lower than control group （P＜0.05）. The utilization rate of combined drugs in ES31 and ES35 patients was significantly lower in the intervention group than control group. In the ES35 disease group （P＜0.05）， the average cost of antibiotics per time in the intervention group was significantly lower than control group （P＜0.05）， and the cost of antibiotics per time of ES35 and ES33 disease groups in the intervention group were significantly lower than ES31 disease group （P＜0.05）. CONCLUSIONS The rational evaluation rules for the clinical application of antibiotics in patients with respiratory system infection/inflammation based on DRG are successfully established， which can be used for comprehensive evaluation of the use of antibiotics； multi-department collaboration control can improve the rational rate of antibiotic use and reduce the medical cost.
