基于医疗联合体的抗菌药物新型管理模式对基层医院儿科抗菌药物合理应用干预研究

目的：探讨以医疗联合体为基础的抗菌药物新型管理模式对基层医院儿科抗菌药物合理应用的干预效果。方法：随机抽取扬州大学附属医院医疗联合体基层医院成员单位抗菌药物合理应用干预前后门诊儿科急性呼吸道感染诊疗日志各200份，统计抗菌药物使用率、联合应用率、抗菌药物人均费用、标本送检率、抗菌药物选择及疗程符合标准指南的比例等，分析干预前后抗菌药物合理应用情况，评价基于医疗联合体的抗菌药物新型管理模式对基层医院儿科抗菌药物合理应用的干预效果。结果：干预后，基层医院儿科急性呼吸道感染抗菌药物使用率、抗菌药物联合应用率、抗菌药物人均费用均降低（P<0.05）；标本送检率、抗菌药物选择及疗程符合标准指南的比例升高（P<0.05）。结论：以区域医疗联合体为平台的抗菌药物新型管理模式，能够指导和干预基层医院儿科抗菌药物合理应用，有效提高基层医院儿科抗菌药物合理应用水平。

Intervention of Rational Application of Antibiotics in Pediatrics of Primary Hospitals Based on New Management Mode of Antibiotics in Medical Alliance

Objective: To probe into the intervention effects of rational application of antibiotics in pediatrics of primary hospitals based on new management mode of antibiotics in medical alliance. Methods: A total of 200 diagnosis and treatment logs of outpatient pediatric acute respiratory tract infection were randomly selected before and after rational application of antibiotics intervention from member units of primary hospitals of medical alliance in Affiliated Hospital of Yangzhou University. The application rate of antibiotics, drug combination rate, per capita cost of antibiotics, specimen delivery rate, selection of antibiotics and proportion of treatment that met standard guidelines were collected. The rational application of antibiotics before and after intervention was analyzed. The intervention effects of the new management mode of antibiotics based on medical alliance on the rational application of antibiotics in children of primary hospitals were evaluated. Results: After intervention, the application rate of antibiotics, drug combination rate of antibiotics and per capita cost of antibiotics in pediatric acute respiratory tract infection in primary hospitals decreased (P<0.05), the specimen delivery rate, selection of antibiotics and proportion of treatment that met standard guidelines increased (P<0.05). Conclusion: New management mode of antibiotics based on medical alliance can guide and intervene the rational application of antibiotics in pediatrics of primary hospitals and effectively improve the rational application level of antibiotics in pediatrics of primary hospitals.