Analysis On The Information Management System Of Hospital Antibiotics In A Hospital And Its Effect

1. PurposesAccording to the regulations and policies of the Ministry of Health on the use of antimicrobial agents for the the traditional lack of antibacterial agents management, information technology tools were used to build a HIS platform antimicrobial management system in hospital in Shanghai. Based on analysis of the use of antibacterial agents in hospital, we examined the effectiveness of the integrated information management, summarize the problem of management system and promote the further improvement of the project. Analysis of situation before and after the implementation of HIS platform included the costs of antimicrobial drug, antimicrobial drugs utilization rate, antibiotics use density(AUD), the percentage of etiology inspection in patients with antimicrobial agents, to demonstrate whether this system can improve the rational use of antimicrobial agents in hospital.2. Contents2.1By analyzing the traditional antimicrobial management processes and existing problems, we construct the antimicrobial information management system in hospital.2.2Research indicators:antibacterial agents utilization rate, antibiotics use density, antibacterial agents inspection rate and antibacterial agents costs.2.3Statistical analysis process2.3.1Analysis of the impact of antibacterial agents2.3.2Contrast of the baseline2.3.3Contrast of the indicators3. Data sources and methods3.1Literature reviewFirst, we reviewed the related literatures through the CNKI, the WangFang Data, VIP database and Internet search engines (such as baidu, Google, and Bing, etc.), understanding the antimicrobial agents, the relevant polcies of the antimicrobial agents, the management of antimicrobial, the effect evaluation theory, current research and pilot program in other hospital. Second, we collected outpatient self-service material, including health policy, the implementation of the promotion measures and project related materials through the Ministry of Health, the official website of the Health Bureau at all levels and health information network academic.3.2Hospital SurveyThe survey included outpatient doctor station, residencies station, nurse station, inspection systems and toll collection system.3.3Source of dataWe investigated the information about the diseases and the use of antimicrobial drugs3months before and after the HIS platform was planted into the manangement of antimicrobials. The main contents included name, gender, age, disease name, etc. Comparative indicators included the varieties of inpatients per capita use of antimicrobial agents, the inpatient per capita use of antimicrobial agents fees, the percentage of patients with antimicrobial agents, antibiotics use density, the percentage of etiology inspection in patients with antimicrobial agents.4. Results4.1Analysis of the traditional process of management of antimicrobial drugs, according to the Ministry of Health documents, combining with the actual situation of the sample hospitals, building information-based antimicrobial management system.4.2Logistic regression analysis showed that the probability of the use of antibiotics the build system is0.73times before the build system, the OR was0.73(P<0.0001), in the age factors,18to40-year-old with the highest probability is18.7times of1to6years of age,OR=18.7(P<0.0001)4.3Group A is before the system, Group B is after the system. Women accounted for50.36%in Group A, men accounted for49.64; women accounted for50.01%in Group B of, men accounted for49.99%, the gap between the two groups was not statistically significant (x2=.3929, P=0.5308).The average age of Group A was49.33±21.07years, Group B was49.56±21.10years. No statistically significant differences exist between the age groups (t=0.65, P=0.5163). 4.4The antimicrobial agents utilization rate in Group A was62.99%,51.40%in group B, a statistically significant difference exist between the groups (x2=156.90, P<0.0001). CMH-x2shows that in addition to the influence of the department, the difference between the groups in antibacterial drug utilization rate still had statistical significance (CMH-x2=1113.3170, p<0.0001).4.5The antibiotics use density in Group A was74.82, Group B was63.05. The difference between the groups was statistically significant (P=0.0495)4.6The inspection rate of antibacterial agents e in Group A was62.68%,73.79%in Group B. The CMH-x2shows that in addition to department factors, the difference between the groups was statistically significant (CMH-x2=9.47, P=0.0021).4.7The antibacterial agents costs was23,136,974yuan in Group A, and25,868,202yuan in Group B. The difference between the groups was not statistically significant (t=-2.21, P=0.0915).5. Conclusions5.1The traditional antimicrobial management methods rely mainly on people’s moral and medical level. The use of antimicrobial agents is difficult to achieve the requirements of the Ministry of Health, especially the antibiotics utilization rate. The antimicrobial utilization rate in the research reached62.99%. The kinds of antimicrobial drugs were too much and the cost was high.5.2According to the traditional management and antibacterial agents data sin hospitals, based on the laws and regulations of the Ministry of Health, we successfully built the antimicrobial management system platform based on information platform in Grade ⅢA hospital in Shanghai.5.3Through the comparison of the data before and after the antimicrobial management system built, we found the antimicrobial drugs utilization rate dropped to the specified value of the Ministry of Health. Antibiotics use density has also decreased and inspection rate have been improved. The system improved the antimicrobial management effectively.5.4Although the the antimicrobial management system achieved a certain effect, but there are a number of shortcomings need to be improved, such as the antibacterial agents cost management, management of special drugs. The improvements of system will make more rational use of antimicrobial.