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[由开处方医生开发的、用于基层医疗中药物处方质量指标的系统]

[A system, developed by prescribing doctors, of indicators of the quality of pharmaceutical prescription in primary care].

作者信息

Gómez Castro M J, Arcos González P, Rubiera López G, Rigueria A I

机构信息

Medicina Familiar y Comunitaria. Departamento de Medicina. Area de Medicina Preventiva y Salud Publica. Universidad de Oviedo. Asturias. Spain.

出版信息

Aten Primaria. 2003 Nov 15;32(8):460-5. doi: 10.1016/s0212-6567(03)79315-9.

DOI:10.1016/s0212-6567(03)79315-9
PMID:14636502
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7668633/
Abstract

OBJECTIVE

To work out a system of indicators and standards, designed by means of a consensus group of general practitioners, that enables evaluation of the quality of Primary Care prescription to be improved. Design. Informal consensus method.

SETTING

A PC area in Asturias with 156 614 inhabitants and 9 health centres.Participants. Nine PC doctors accepted voluntarily to take part in the project.

METHOD

A consensus group of nine PC doctors was formed. At a first meeting they worked out some potential indicators of quality of prescription. After applying these indicators to the prescription data, a second meeting was held, at which the results of applying the indicators along with criteria of excellence were used to establish the definitive indicators and their numerical values of optimum compliance.

RESULTS

It was possible to agree by consensus 11 indicators of quality of prescription and their values of optimum compliance. Eight of the indicators referred to choice of a medicine within a pharmaco-therapeutic group; and three, to groups in which the volume of prescription may suggest improper usage.

CONCLUSIONS

It is feasible for PC doctors to reach a consensus on a group of criteria that is perceived as valid for measuring quality of prescription and which includes certain impalpable values for determining quality.

摘要

目的

通过全科医生共识小组设计一套指标和标准,以改进对初级保健处方质量的评估。设计:非正式共识方法。

背景

阿斯图里亚斯的一个初级保健区域,有156614名居民和9个健康中心。参与者:9名全科医生自愿参与该项目。

方法

成立了一个由9名全科医生组成的共识小组。在第一次会议上,他们制定了一些处方质量的潜在指标。将这些指标应用于处方数据后,召开了第二次会议,会上利用应用指标的结果以及卓越标准来确定最终指标及其最佳依从性的数值。

结果

通过共识确定了11项处方质量指标及其最佳依从性数值。其中8项指标涉及药物治疗组内药物的选择;3项指标涉及处方量可能表明使用不当的组。

结论

全科医生就一组被认为对衡量处方质量有效的标准达成共识是可行的,这些标准包括某些难以捉摸的质量判定值。

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本文引用的文献

1
[Explanatory variables of avoidable cost produced by not prescribing a cheaper equivalent drug].
Gac Sanit. 2001 Nov-Dec;15(6):513-8. doi: 10.1016/s0213-9111(01)71614-7.
2
[Opinion of primary care physicians from Ourense on various features of the pharmaceutical prescription].[奥伦塞初级保健医生对药物处方各种特征的看法]
Rev Esp Salud Publica. 2001 Jul-Aug;75(4):361-73.
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[Factors conditioning prescription in primary care].[基层医疗中影响处方开具的因素]
Aten Primaria. 2001 Jan;27(1):43-8. doi: 10.1016/s0212-6567(01)78772-0.
4
Prescribing indicators for UK general practice: Delphi consultation study.英国全科医疗的处方指标:德尔菲咨询研究
BMJ. 2000 Aug 12;321(7258):425-8. doi: 10.1136/bmj.321.7258.425.
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[Analysis of drug consumption with indicators of prescription quality].[使用处方质量指标对药物消费进行分析]
Aten Primaria. 2000 May 31;25(9):618-24. doi: 10.1016/s0212-6567(00)78582-9.
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Non-steroidal anti-inflammatory drugs.非甾体抗炎药。
BMJ. 2000 Apr 15;320(7241):1058-61. doi: 10.1136/bmj.320.7241.1058.
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Prescribing benzodiazepines--a critical incident study of a physician dilemma.
Soc Sci Med. 1999 Aug;49(4):459-67. doi: 10.1016/s0277-9536(99)00133-1.
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General practitioners' perceptions of effective health care.全科医生对有效医疗保健的看法。
BMJ. 1999 Jun 5;318(7197):1532-5. doi: 10.1136/bmj.318.7197.1532.
9
[Determinants of clinical decision making in primary care: opinion of physicians].
Aten Primaria. 1998 Nov 15;22(8):505-13.
10
Controversies in primary care. Setting prescribing budgets in general practice. Capitation based prescribing budgets will not work.基层医疗中的争议。在全科医疗中设定处方预算。基于人头数的处方预算行不通。
BMJ. 1998 Mar 7;316(7133):748-50. doi: 10.1136/bmj.316.7133.748.