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基于 360 度反馈评价法和犹豫模糊集理论的合理用药评价模
型建立 Δ
王文杰 ,刘玉颖,黄 哲(沈阳药科大学工商管理学院,沈阳 110016)
*
#
中图分类号 R951;R969.3 文献标志码 A 文章编号 1001-0408(2019)02-0154-06
DOI 10.6039/j.issn.1001-0408.2019.02.03
摘 要 目的:建立全方位、多角度的医疗机构合理用药评价模型,为提高医疗机构的合理用药水平提供方法支持。方法:基于
360度反馈评价法,以同级医院、上级监管机构、患者为多角度评价主体,针对医疗机构不合理用药现象及影响因素,构建包含3个
评价主体、6个一级指标及15个二级指标在内的合理用药评价指标体系;同时结合犹豫模糊集理论对评价主体给出的模糊、不确
定性评价语言信息进行综合量化处理,通过犹豫模糊数得分函数公式计算被评价医疗机构合理用药的总评价得分,并根据该分值
的高低判定医疗机构合理用药水平(总评价得分越高,则合理用药综合水平越高)。结果:建立了全方位、多角度的医疗机构合理
用药评价模型,该模型根据基于360度反馈评价法构建的评价指标体系,确定了评价主体、评价指标权重,划分了指标评分等级,
集结了各级指标的犹豫模糊数并对一级指标进行加权,最终计算获得医疗机构合理用药的总评价得分;通过算例演示证明该模型
可行。结论:基于360度反馈评价法和犹豫模糊集理论建立的医疗机构合理用药评价模型能更加全面、有效地对医疗机构合理用
药水平作出评价,有助于医疗机构针对性地规范和改进临床用药行为。
关键词 360度反馈评价法;犹豫模糊集理论;合理用药;指标体系;评价模型
Establishment of Rational Drug Use Evaluation Model Based on 360-degree Feedback Evaluation Method
and Hesitant Fuzzy Sets Theory
WANG Wenjie,LIU Yuying,HUANG Zhe(School of Business Administration, Shenyang Pharmaceutical
University,Shenyang 110016,China)
ABSTRACT OBJECTIVE:To establish a comprehensive and multi-angle evaluation model for rational drug use in medical
institutions,and to provide support for rational drug use in medical institutions. METHODS:Referring to the phenomenon of
irrational drug use and its influential factors in medical institutions,rational drug use evaluation indicator system,which contained
3 evaluation subjects,6 first-level indicators and 15 second-level indicators,was established on the basis of 360-degree Feedback
Method,with hospitals at the same level,superior regulation department and patient as subjects of multi-angle evaluation. At the
same time,the linguistic information of vague and uncertain evaluation given by the evaluation subject was comprehensively
quantified by Hesitant Fuzzy Sets Theory. The total evaluation score of rational drug use in the evaluated medical institutions was
calculated by using the score function formula of hesitant fuzzy number;the level of rational drug use in medical institutions was
determined according to the score(the higher the total score,the higher the comprehensive level of rational drug use). RESULTS:An
all-round and multi-angle evaluation model of rational drug use in medical institutions was established. According to the evaluation
index system based on 360-degree feedback evaluation method, the evaluation subject and weight of evaluation index were
determined,the grade of evaluation index was divided,the hesitant fuzzy numbers of each index were gathered,and the first-level
index was weighted. Finally,the total evaluation score of rational drug use in medical institutions was calculated;the examples were
set to prove the feasibility of the model. CONCLUSIONS:The established evaluation model for rational drug use in medical
institutions based on 360-degree Feedback Method and Hesitant Fuzzy Sets Theory can comprehensively and effectively evaluate the
rational drug use in medical institutions,and contribute to standardizing and improving clinical drug use behavior in medical institutions.
KEYWORDS 360-degree Feedback Method;Hesitant Fuzzy Sets Theory;Rational drug use;Index system;Evaluation model
不合理用药现象在全球范围内普遍存在,据世界卫 且对患者的健康有不利影响。合理用药是医疗机构体
生组织(WHO)统计,全球有一半以上的药物被不合理地 现自身医疗服务能力的重要组成,具有非常重要的社会
[1]
应用 。药物不合理应用不仅会造成医疗资源浪费,而 意义。Keohavong B、Atif M等学者提出,应该对医疗机
Δ 基金项目:教育部人文社会科学研究一般项目(No.18YJC- 构的合理用药情况进行评价,以发现治疗过程中存在的
ZH060);辽 宁 省 教 育 厅 高 校 基 本 科 研 项 目(人 文 社 科 类) 不合理用药问题,并及时制定相应的解决措施 [2-3] 。国内
(No.2017WZD03);沈阳药科大学科研专项基金项目(No.2017012) 外已有很多合理用药相关研究的报道,例如Mahmood A
*硕士研究生。研究方向:药事管理。E-mail:871783952@qq.
[4]
等(2016) 采用多中心前瞻性横断面对比研究方法,对
com
# 通信作者:副教授,博士。研究方向:决策管理。E-mail:huang- 阿拉伯联合酋长国进行了合理用药评价;Wang H 等
[5]
zhe2000@sina.com (2013) 对我国县级医院的处方模式和影响因素进行了
·154 · China Pharmacy 2019 Vol. 30 No. 2 中国药房 2019年第30卷第2期