Construction And Application Of Rational Drug Evaluation Index System In Community Health Service Center

Objective:To understand the scientific,rational and feasible rational drug evaluation index system applicable to community health service centers on the basis of understanding the actual situation of drug use at the grassroots level,especially community health service centers,and to clarify the proportion of each indicator.The overall evaluation of the indicator system proposes rationalization proposals.On the one hand,it is convenient for community health service centers to compare with peers in the process of conducting rational drug evaluation,find gaps,and timely discover rational drug use problems or risk trends;on the other hand,it is reasonable to change the grassroots level to improve only through single or partial indicators.Improve the thinking of medication,strengthen the systematic and overall improvement of the rational use of medicines,and promote the overall rational use of medicines in community health service centers through a multi-dimensional joint efforts.Methods:Firstly,introduce the basic service capacity and rational use of drugs in grassroots,especially community health service centers in China,and understand and sort out some typical drug evaluation methods at home and abroad through the literature research method,and initially extract the appropriate drug evaluation system suitable for inclusion in community health service centers index.Secondly,using the Delphi method,two rounds of expert consultations were conducted for some health administrative personnel,responsible persons of grassroots medical institutions,doctors,pharmacists,and research scholars in the field of pharmacy management,and the preliminary evaluation indicators were scored,screened,adjusted,and improved.Until the final determination and formation of a complete community health service center rational drug evaluation index system.Furthermore,according to the vested rational drug evaluation index system,through the questionnaire survey method,key person interview method and TOPS IS method,the rational drug use level of five community health service centers in Yuhuatai District of Nanjing was evaluated,and the level was from high to low.Sort.Finally,relevant policy recommendations are proposed on how to further improve the rational use of drugs in community health service centers.Results:The community drug service center rational drug evaluation index system determined by expert consultation contained 4 first-level indicators,namely,outpatient prescription(27.93%),outpatient care(23.24%),and medical staff(26.29%),management of medical institutions(22.54%).In the first-level indicator outpatient prescription,the top five indicators of weight ranking are:the average number of prescription drugs per prescription(3.30%),the usage rate of generic drugs(3.30%),and the average prescription cost of a single prescription(3.22%).),basic drug use rate(3.19%),hormone use rate(3.12%);In the first-level indicators outpatient care,the top five secondary indicators are:drug use dose awareness rate(2.80%),average drug take Time(2.78%),average visit time(2.77%),drug use awareness rate(2.68%),drug treatment effect satisfaction rate(2.68%);In the first-level indicator medical staff performance,ranked top five Indicators include:whether the prescription system is equipped with reasonable medication software(3.15%),the proportion of undergraduate and above pharmacists(3.11%),the proportion of undergraduate and above physicians(3.08%),and the quarterly participation in rational medication continuing education or training(3.05%),the number of pharmacists(3.04%);In the management of the first-level indicators medical institutions,the top five indicators are:the function of the Pharmacy Management and Drug Therapy Committee(group)(3.04%),equipped with essential drug list or fonnulary(2.78%),number of rational drug-related documents developed and implemented by medical institutions(2.77%),regular reporting mechanism for drug information(2.74%),quarterly rational drug use education or training times(2.73%).Based on the rational drug evaluation index system constructed in this study,the evaluation results of rational drug use level of 5 community health service centers in Yuhuatai District of Nanjing show that the community A has the highest level of rational drug use,and the community C has the lowest level of rational drug use.The middle level is community E,community D,community BConclusions and recommendations:The rational evaluation index system for community health service centers constructed in this study finally includes 4 first-level indicators and 34 second-level indicators.This evaluation index system reflects the important links and factors of doctors,pharmacists,nurses,and patients involved in rational drug use,and has strong scientific and practical characteristics.Regarding how to improve the rational use of drugs in community health service centers,it is mainly based on five aspects to propose countermeasures.(1)In terms of outpatient prescriptions:First,increase the intensity of prescription reviews and continue to improve the quality of prescriptions;Second,optimize the rational drug use intervention system and strengthen supervision of physician prescriptions.(2)In terms of outpatient care:First,optimize the patient service process and promote the improvement of community health service quality;Second,implement rational drug use education and improve the rational use of drugs by community residents.(3)In the performance of medical personnel:First,to ensure the cultivation and reserve of community health service personnel by virtue of the advantages of the medical association platform;Second,to strengthen the professional ethics education of physicians and consciously improve the professional level;Third,to strengthen the construction of grassroots pharmacists,and gradually Conduct a pilot of clinical pharmacists.(4)In the management of medical institutions:First,maintain normal education and strengthen the rational use of medical training for medical personnel;Second,implement the reform of the salary system and improve the performance appraisal system for medical personnel.(5)In the decision-making of government departments:First,implement government responsibilities and ensure full financial compensation;Second,strengthen multi-dimensional assessment of drug selection and scientifically formulate basic drug catalogue;Third,promote pharmacist legislative process and establish pharmacy service charging project and standard.