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Outline
To explore the correlation between Case Mix Index (CMI) and Antimicrobial Usage Density (AUD), construct a tiered management model for AUD, optimize the management of antimicrobial agents in the entire hospital, and improve the quality of antimicrobial management.
Data on CMI, AUD, and other antimicrobial usage-related indicators from 41 clinical departments of a tertiary general hospital in 2023 were collected. Linear regression models and multivariate regression analysis were used to investigate the relationship between CMI and AUD and other antimicrobial usage indicators. The optimal model was determined using the Rank Sum Ratio (RSR), and tiered management of AUD was implemented based on the this optimal model.
The fitting coefficient (R2) of the CMI×Antimicrobial Usage Rate×AUD model was 0.522, which was significantly higher than that of other AUD linear regression models (P <0.05), indicating a superior fit. Using this model, the RSR was calculated, and a linear regression equation was established:y =0.120 3x-0.102 6, with R2=0.899. Analysis of variance showed F =357.112 and P < 0.001, indicating that the regression equation constructed with the RSR based on this model was well-established and statistically significant. After adjusting AUD with CMI and antimicrobial usage rate, the tiered results of 10 departments (24.40%) changed, with 5 departments being upgraded and 5 downgraded in management level. Following the implementation of tiered AUD management, the overall antimicrobial usage intensity in the hospital decreased by 4.22% in 2024 compared to 2023. The 8 strictly controlled departments showed an average AUD reduction of 5.89%, indicating a satisfactory overall management effect.
Adjusting AUD with CMI and antimicrobial usage rate can enhance the accuracy of antimicrobial usage evaluation and provide a scientific basis for hospital antimicrobial management.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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