HuaZhong University of Science and Technology, Wuhan, Hubei, China.
PLoS One. 2013 May 10;8(5):e63225. doi: 10.1371/journal.pone.0063225. Print 2013.
This study aimed to investigate prescription patterns and influencing factors in Chinese county hospitals.
Prescription quality was evaluated by five indicators proposed by WHO/INRUD. A questionnaire for doctors was designed by our research group. All internists, surgeons, obstetricians, gynecologists and pediatricians from 10 county hospitals in Anhui province were asked to fill the questionnaire. Their prescriptions from May 2011 to April 2012 were analyzed.
Three-hundred and thirty-seven doctors completed valid questionnaires, and 5099 prescriptions were analyzed. The average number of drugs per prescription was 3.52±2.31; the average percentage of generic drugs, antibiotic usage, injection drug usage, and drugs prescribed from the national essential drug list were 96.12%, 29.90%, 20.02% and 48.85%, respectively. Differences in final academic degree and specialty led to differences in all of the five prescription quality indicators. The older doctors tended to use more antibiotics. Doctors with more education, more training on rational drug use, and better acquisition of medicine knowledge prescribe a lower percentage of generic drugs. Moreover, the more supportive the doctor's attitude to national essential medicine policy, the higher the percentage of generic drugs were prescribed. A higher level of medical knowledge was associated with a higher percentage of drugs prescribed from the essential drugs list.
Promoting the education of medical knowledge on doctors, reinforcing the publicity of rational drug use to doctors, and initiating the performance evaluation for doctors are effective ways for improving prescription quality in Chinese county hospitals.
本研究旨在调查中国县级医院的处方模式和影响因素。
采用世界卫生组织/国际合理用药网络（WHO/INRUD）提出的 5 项指标评价处方质量，由研究组自行设计医生调查问卷，对安徽省 10 所县级医院的全部内科、外科、妇产科、儿科医生进行问卷调查，并对其 2011 年 5 月至 2012 年 4 月的处方进行分析。
共发放问卷 337 份，回收有效问卷 337 份，有效处方 5099 张。每张处方平均用药品种数为 3.52±2.31；处方中使用通用名药物、抗生素、注射剂、国家基本药物的百分率分别为 96.12%、29.90%、20.02%、48.85%；不同最终学历和专业的医生在处方质量 5 项指标上存在差异。随着医生年龄的增长，抗生素的使用率呈升高趋势。学历越高、接受合理用药培训越多、获取药品知识的途径越多，处方中使用通用名药物的百分率越低；对国家基本药物政策的支持态度越积极，处方中使用通用名药物的百分率越高。医生的医学知识水平越高，使用国家基本药物的百分率越高。
加强对医生医学知识的教育，强化对医生合理用药的宣传，启动对医生的绩效考核，是提高中国县级医院处方质量的有效途径。
