摘要
目的应用2015版Beers标准,综合分析不同级别医院老年住院患者潜在不适当用药现况及影响因素。方法选择西安医学院下属的3家不同等级的教学医院,随机抽取2017年1-6月724例老年住院患者的病案,对其进行统计描述及多因素二元Logistic回归分析。结果 (1)老年人住院患者潜在不适当用药发生率为78.59%,不同等级医院发生率分别为:二甲(46.00%),三乙(76.67%),三甲(83.71%)。(2)进入Logistic回归模型的5个因素是联合用药数量、年龄、医保类型、医院等级及主管医生年资,回归模型具有统计学意义(χ2=161.65,P<0.001),该模型的预测正确率为86.9%,总说服力为32.4%。结论老年住院患者潜在不适当用药的发生率高,尤其是三甲医院。再者,患者年龄越大、医保报销比例越高、联合用药数量越多、医院级别越高、主管医生年资越低,越容易发生老年住院患者潜在不适当用药。
Objective To comprehensively analyze the current situation and influencing factors of the potential inappropriate medication （PIM） in geriatric inpatients in the hospitals of different levels based on 2015 Beers criteria. Methods Totally 724 case reports of hospitalized patients of old age from January to June in 2017 were randomly selected from the three different teaching hospitals of different levels affiliated to Xi＇an Medical University,the data was analyzed through the statistical description and multivariate Logistic regression. Results The PIM rate in geriatric inpatients was 78.59% ,and the proportion of the different-level hospitals was as follows ：46. 00% in hospital of 2A, 76. 67% in hospital of 3B, and 83.71% in hospital of 3A. The five factors in Logistic regression model were the spe- cies of combined use of drug, age, the type of medical insurance, level of hospital and the qualification of attending doc- tors. The regression model was statistically significant （X2 - 161.65, P 〈 0. 001 ）, and the prediction accuracy of the model was 86. 9% ,R2 - 32.4%. Conclusion The incidence of the PIM in gerialric inpatients is high, especially in hospital of 3A. Furthermore,geriatric inpatients are more prone to have PIM when the patients are older,the ratio of reimbursement or the grade of hospital is higher, and the species of drug in combination use and the qualification of doctor-in-charge is lower.
作者
张海苗
张博江
褚静
杨瑞亚
杨成
ZHANG Hai-miao;ZHANG Bo-jiang;CHU Jing;YANG Rui-ya;YANG Cheng(Xi＇an Medical University, Xi＇ an 710021, China;Shaanxi Provincial People＇ s Hospital, Xi＇ an 710068, China;Xi ＇ an Beihuan Hospital, Xi＇an 710032, China)
出处
《实用药物与临床》
CAS
2018年第4期448-451,共4页
Practical Pharmacy and Clinical Remedies
基金
省级重点学科建设项目(16hlxk14)
