某三级甲等综合医院抗菌药物使用强度的波士顿矩阵评价OA

Objective To promote the compliance of antimicrobial use density(AUD)in hospitals.Methods Data from the front pages of discharge cases of 28 clinical departments of a tertiary first-class general hospital from January 2022 to June 2024 were collected.The case mix index(CMI)and defined daily doses(DDDs)of antimicrobials were calculated for each department.The median method was used to establish the interval assessment target values for DDDs.A Boston matrix was constructed with CMI value as the horizontal axis and DDDs value as the vertical axis,using(1,34)as the coordinate intersection point,each clinical department was managed based on the results,and the actual control effectiveness of DDDs in each clinical department was dynamically evaluated before management implementation(2022,using a single target value)and after management implementation(2023 and the first half of 2024,using interval assessment target values).Results Compared with 2022,the overall hospital DDDs value decreased by 3.75 and 4.13 in 2023 and the first half of 2024,respectively,while the CMI value increased by 0.01 and 0.04,respectively.Both the overall hospital DDDs and CMI gradually approached the target values.Boston matrix analysis showed that,compared with before management implementation,the number of clinical departments in Quadrant I(laissez-faire zone)remained unchanged(still seven departments),the number in Quadrant Ⅱ(strict control zone)decreased from seven to four,the number in Quadrant Ⅲ(encouragement zone)increased from 10 to 11,and the number in Quadrant Ⅳ(commendation zone)increased from four to six after management implementation.Conclusion The established Boston matrix can be used for dynamic evaluation of interval assessment of antimicrobial DDDs,helping to guide the management and optimization of AUD and promoting rational drug use in clinical departments of the hospital.