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目的了解并评估《处方管理办法》实施以来,医疗机构开展处方评价工作的现状、效果及存在的问题,为规范我国医疗机构处方评价,提高处方评价水平提供决策依据。方法采用文献计量学方法,对比分析《处方管理办法》实施前后中国医院数字图书馆收录的与处方评价工作相关的文献;统计文章数量,分析汇总期刊分布、评价指标的变化及存在的问题。结果《办法》实施前,处方评价指标主要由处方和技术指标构成,发表文献数量为572篇;实施后,新《办法》根据合理用药国际指标做了调整,并引入了患者关怀指标,发表文献数量达到了2 101篇。由于各级医疗机构药事部门对《办法》中规定指标的理解存在偏差,文献报道存在抽样方法、指标标准、指标种类(本级指标与区域指标)、指标表述等的不一;涉及患者关怀指标的文献少,占1.48%(31∶2 101);重复性文献多。结论处方合格率是《办法》颁布前我国医疗机构处方评价工作表达的唯一指标,也是一项综合指标。《办法》实施后,医疗机构处方评价的内容发生了质的变化,特别是合理用药国际指标引入并写入《办法》后,医疗机构的处方评价工作的指标多样化、结果多样化,注重单项指标,对促进合理用药工作更具可操作性。但由于各级医疗机构对《处方管理办法》的理解存在偏差,导致执行《办法》随意性大,无法整体了解我国处方管理的现状。总体来说,处方评价,规范了临床诊疗行为,提高了药物治疗水平和药物治疗管理水平。
Objective To understand and assess the status quo, effectiveness and existing problems of prescription evaluation work carried out by medical institutions since the implementation of the Measures for the Administration of Prescription Management, and to provide decision-making basis for regulating prescription evaluation of medical institutions in China and improving the level of prescription evaluation. Methods Bibliometrics was used to compare and analyze the literature related to prescription evaluation collected by the Chinese Hospital Digital Library before and after the implementation of the “prescription management approach”. The number of articles, the distribution of journals, the changes of evaluation indexes and the existing problems were analyzed. Results Before the implementation of the Measures, the prescription evaluation index consisted mainly of prescriptions and technical indicators with a published quantity of 572 articles. After the implementation, the new Measures were adjusted according to the international indicators of rational drug use, introduced the patient care indicators and published the articles The number reached 2 101 articles. As medical institutions at all levels of medical institutions on the “measures” in the understanding of the provisions of the indicators there is a deviation, there are sampling methods reported in the literature, the index standard, the type of indicators (level indicators and regional indicators), indicators such as the different expression; involving patient care Indicators of the literature less, accounting for 1.48% (31:2 101); repetitive literature. Conclusion The passing rate of prescription is the only indicator of the prescribing evaluation work of medical institutions in our country before the promulgation of the Measures, which is also a comprehensive index. After the implementation of the Measures, the content of the prescription evaluation of medical institutions has undergone a qualitative change. Especially after the introduction and writing into the Measures of International Indexes of Rational Drug Use, the indicators of the prescribing evaluation of medical institutions are diversified and the results are diversified. Individual items Indicators, to promote the rational use of drugs more operational. However, due to the misunderstanding of “prescription management measures” at all levels of medical institutions, the implementation of the “measures” is arbitrary and can not fully understand the current situation of prescription management in our country. In general, prescribing evaluation standardized the clinical diagnosis and treatment, and improved the level of drug treatment and drug treatment management.