目的 了解我院住院患者抗菌药物的临床应用现状及存在问题，为临床合理使用抗菌药物提供参考。 方法 采用回顾性调查方法，对本院2008年11月-2009年4月的出院病历资料进行统计、分析。 结果 共调查病历1 000份，抗菌药物总使用率58.70％；其中预防用药使用率62.35％，治疗用药使用率37.65％；联合用药的比例为37.31％；不合理用药占19.76%。 结论 抗菌药物使用率较高，且使用存在一些不合理现象。医院应加强监管，对存在的问题应制订相应措施。
ObjectiveTo describe the status of epilepsy inpatients healthcare service in tertiary public hospitals in China by the data collected from the Hospital Quality Monitoring System.MethodsA population-based study was conducted with data of hospitalized patients collected from the Hospital Quality Monitoring System between 2015 and 2017. Diagnoses were identified by International Statistical Classification of Diseases and Related Health Problems 10th Revision codes for epilepsy (G40). The information of demographic characteristics, costs, payment methods, and discharge status were extracted and analyzed annually to make cross-sectional studies.ResultsA total of 329 241 hospitalized epilepsy patients from 585 tertiary public hospitals were identified. The average age of the patients was 31.74 and male patients accounted for 60.00% of the total. The proportion of patients covered by the national basic medical insurance in the three years was 50.15%, and that in the year 2015, 2016, and 2017 was 49.03%, 49.79%, and 51.80%, respectively; the proportion of patients with full self-payment was 30.40%. The average length of hospital stay was 6.65 d, the average cost for each stay was 7 985.53 yuan, the average self-payed cost for each stay was 3 979.62 yuan. In terms of the discharge way of the patients, 88.02% discharged following doctors’ advice, 0.40% were transferred to another hospital with doctors’ advice, and 6.59% discharged against doctors’ advice. The in-hospital mortality in the three years was 0.16%, and that in the year 2015, 2016, and 2017 was 0.19%, 0.16%, and 0.12%, respectively.ConclusionThe study shows that the in-hospital mortality rate of epilepsy inpatients in the tertiary public hospitals in China decreased gradually from 2015 to 2017, the coverage rate of national basic medical insurance increased year by year, and there is still room for further improvement.
ObjectiveTo evaluate the conditions of activity of daily living (ADL) and influence factors of ADL of hospitalized elderly (≥60 years old) patients. MethodsA cross-sectional study was conducted to investigate the health and ADL conditions of hospitalized elderly patients in the geriatric department of a tertiary hospital in Chongqing by ADL scale. The influence factors of ADL were analysed by using logistic regression analysis. ResultsA total of 375 hospitalized elderly patients were included. The ADL impairment rate of female was 59.60% (93/156), the one of male was 75.90% (166/219), and there was significant difference between different sex (χ2=11.169, P=0.001). The impairment rate by age were 95.40% at 60 to 69 years old, 91.40% at 70 to 79 years old, 87.20% at 80 to 89 years old, and 98.55% at above 90 years old, respectively; there was significant difference among different age groups (χ2=8.575, P=0.036). The result of logistic regression analysis showed that age was the individual risk factor of ADL (OR=0.188, 95%CI 0.085 to 0.416, P=0.000). The difficulty of walking up and down stairs occupied the highest proportion (68.80%) in 10 items of ADL scale. ConclusionHospitalized elderly patients should be equipped with specialized paramedics to minimize the difficulties of ADL, in order to improve their quality of life.
目的 了解住院患者病死率以及死亡病例的年龄、性别及主要死因的分布状况，为疾病预防治疗提供科学依据。 方法 对重庆医科大学附属第二医院2007年1月－2011年12月3 030例住院死亡患者进行统计分析，根据国际疾病分类第10版（ICD-10）进行疾病分类，所有资料经SPSS 13.0软件进行统计分析。 结果 该院近5年共有出院患者173 411例，死亡3 030例，病死率1.75%。各年龄段男性患者病死率均高于女性。各年度、不同性别前3位死因均依次为：肿瘤、循环系统疾病、呼吸系统疾病。 结论 慢性非传染性疾病是住院患者的主要死亡原因。提高医疗技术水平、普及群众的预防保健知识、大力开展健康体检是降低病死率的主要措施。
ObjectiveTo improve activities of daily living (referring to Barthel Index) in the older inpatients.MethodsIn January 2016, a quality control circle (QCC) was established. According to 10 steps in activity of QCC, we figured out the causes of low Barthel Index score in older inpatients by using Plato method and Fishbone Diagram which were common methods of QCC. In addition, we designed and implemented a rectification program to improve Barthel Index score.ResultsAfter intervention of QCC, the average Barthel Index score of the older inpatients increased from 72.40±6.42 to 89.30±5.87 with a statistical difference (P<0.01); the satisfaction percent of hospitalized patients increased from 94.5% to 98.7% with a statistical difference (P<0.01). The percentage of registered nurses whose theoretical test score were over 90 increased from 57% to 88% (P<0.01) and the satisfaction percent of nurses increased from 90.5% to 95.6% (P<0.01). Moreover, the member’s ability of learning, discovery, analysis and problem solving, communication, application of QCC skills were improved.ConclusionThe application of QCC activities will increase older inpatients’ Barthel Index score, improve the satisfaction of patients and nursing staff, and enhance the members’ ability of solving problems by using QCC skills.
目的:比较早期预警评分(EWS)和改良早期预警评分(MEWS)预测急诊住院患者死亡风险的能力。方法:随机抽取409名四川大学华西医院急诊住院患者,采用EWS和MEWS对患者进行评分,使用ROC曲线比较两者预测急诊住院患者死亡风险的能力。结果:EWS预测患者住院的曲线面积为0.849±0.132,其最佳截断值为4分;MEWS预测急诊患者住院的曲线下面积为0.876±0.124,其最佳截断值为5分。结论:MEWS较EWS对于预测急诊住院患者死亡风险有较高的效能,还可以进一步改进提高其预测能力。
Objective To investigate drug usage and costs of chronic obstructive pulmonary disease (COPD) inpatients in Karamay Central Hospital in 2014 and to provide evidence and reference for evidence-based pharmacy study on COPD. Methods The information of drug use and expenditure of COPD inpatients were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 194 inpatients with COPD/AECOPD were included in Karamay Central Hospital in 2014, the average age was 74.28±7.81 years old. Fifty-three drugs were used for COPD treatment; the total frequency were 1 798 times and per capita cost was 7 419.78 yuan. The top three used drugs were budesonide suspension, montelukast tablets and methylprednisolone injection. In total expenditure, the cost of piperacillin-tazobactam, imipenem/cilastatin and moxifloxacin injection ranked top three. Conclusion The top 3 used drugs are budesonide suspension, montelukast tablets and methylprednisolone injection for COPD inpatients in Karamay Central Hospital in 2014, while the top 3 total expenditure drugs are piperacillin-tazobactam, imipenem/cilastatin and moxifloxacin injection.
ObjectiveTo investigate the use of traditional and new-type antidepressants in the in-patients with depressive disorder. MethodsThe antidepressant use of 165 in-patients with depressive disorders from March 1st to April 30th, 2013 were investigated. ResultsThe new-type antidepressants became the best drug in clinic, and single drug use was carried out mostly. The most used drug was atypical antipsychotics. ConclusionThe use of antidepressant drugs in the in-patients with depressive disorder in our hospital is regular and reasonable.
Objective To investigate constitution and costs of inpatients with circulation system diseases in Karamay Central Hospital in 2014 and provide baseline data for further evidence-based pharmacy studies of circulation system single disease. Methods The information of drug use and expenditure of circulation system diseases were collected from the hospital information system (HIS). We analyzed the data of frequency, constituent ratio and cumulative frequency by using Excel 2007 software. Results A total of 2 898 inpatients with circulation system diseases were included. The top three diseases were cerebral infarction, angina and hypertension. The cerebral infarction and coronary heart disease accounted for the largest proportion in the cost. The top one disease of total hospitalization cost, drug expense per capita and inspection cost per capita was cerebral infraction. Conclusion Based on the above results, cerebral infraction and angina were selected as the evidence-based pharmacy study goal of single disease.