基于绩效支付的抗微生物管理对抗微生物消费和支出的影响:中断时间序列分析
Haohai Xia1, Jia Li2, Xinyi Yang1
1School of Public Health, Sun Yat-sen University, Guangzhou, China.
按绩效支付的倡议在短期内在减少特定医院部门的抗菌药物消费方面取得了成功. 然而,长期影响和整个医院的整体有效性仍然有限,这表明需要进一步改进战略.
科学领域:
- 医疗保健管理的管理
- 传染病控制和控制传染病
- 药物经济学 药物经济学
背景情况:
- 抗生素耐药性需要优化抗生素使用的策略.
- 按绩效支付 (PFP) 模式越来越多地被实施,以影响医疗保健提供者的行为.
- 评估PFP对抗微生物药物管理的影响对于公共卫生至关重要.
研究的目的:
- 评估一项绩效支付计划对抗微生物消费和支出的影响.
- 分析抗生素使用密度 (AUD) 和抗生素使用率 (AUR) 的短期和长期趋势.
- 为了确定PFP干预措施在一个大型教学医院的经济影响.
主要方法:
- 从2018年1月到2022年9月在住院病房收集的数据.
- 用AUD和AUR来衡量抗菌剂的消耗.
- 以抗微生物药物支出比例评估的经济影响.
- 用于数据评估的中断时间序列 (ITS) 分析.
主要成果:
- 在血液学,泌尿学,胃肠道外科,心脏外科和ICU中观察到AUD的立即下降.
- 在器官移植部门注意到AUD的长期下降趋势.
- 在泌尿病学和胃肠道外科观察到的AUR的短期下降.
- 在儿科ICU和ICU Unit 1中发现的AUR的长期下降趋势.
结论:
- 在短期内,PFP有效地减少了特定医院部门的抗生素消耗.
- PFP干预措施对抗微生物药物的长期影响是有限的.
- 整体而言,PFP干预的全医院有效性在统计学上并不显著.
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