利用社會網絡分析挑出重複用藥的關鍵樞紐部門

Social network analysis of duplicate prescriptions to identify key departments

林為森(Weir-Sen Lin) ； 錢才瑋(Tsair-Wei Chien)

《醫務管理期刊》 17卷3期 (2016/09) Pp. 232-246

https://doi.org/10.6174/JHM2016.17(3).232

摘要

目的：利用社會網絡分析挑出重複用藥的關鍵樞紐部門，作為主管機關與醫院改善之參考。方法：自5類型醫療院所的2015年第4季門急診健保申報資料中，擷取823,005筆藥品，對應病人時間重疊的藥理分類系統前5碼相同者3,520筆。利用(1)基本統計學挑出重複用藥最多的部門及其開立的藥品、(2)社會網絡分析挑出重複用藥的關鍵樞紐部門。結果：挑出(1)重複用藥最多的部門為醫院A的麻醉科（76.74%）、醫院D的內分泌科（73.33%）、及醫院D的消化內科（73.33%）、(2)重複用藥最多的藥品為理冒伯樂止痛錠及伯基腸溶微粒膠囊100公絲、(3)重複用藥的關鍵樞紐部門為醫院ABC的3家醫院急診醫學部門。結論：利用社會網絡的主成份分析視覺化挑出重複用藥的「關鍵樞紐部門」為醫院的急診醫學科，宜優先訴求改善與注意，作為醫院進行持續性改善重複用藥的依據與參考。

關鍵字

重複用藥 ； 社會網絡分析 ； 急診醫學部門 ； 關鍵樞紐部門

並列摘要

Objectives: To identify the departments with the most duplicate prescriptions in outpatient sections by using social network analysis (SNA) Methods: Data for duplicate prescriptions from the fourth quarter of 2015 were retrieved from the reimbursement claims to Taiwan's government-run National Health Insurance Department. Data including 823,005 items from five different health care institutions were used to match the first 5 digits of the Anatomical Therapeutic Chemical dataset, and 3,520 duplicate prescriptions were then identified. We utilized (1) a foundational statistical technique to identify the highest rates of duplicate prescriptions by department and by drug, and (2) SNA to identify the key departments writing duplicate prescriptions. Results: (1) The highest rates of duplicate prescriptions by department were in the anesthesiology department of Hospital A (76.74%) and the endocrinology (73.33%) and digestive system departments (73.33%) of Hospital D. (2) The highest rates of duplicate prescriptions by drug were for FUCOLE PARAN TABLETS (acetaminophen) and BOKEY ENTERIC-MICROENCAPSULATED CAPSULES 100MG (aspirin). (3) The key departments were the emergency departments of Hospitals A, B, and C. Conclusions: The SNA principal components method is useful in identifying the key departments in terms of duplicate prescriptions and may be the first step in reducing the number of duplicate prescriptions in healthcare settings.

並列關鍵字

duplicate medication ； social network analysis ； emergency department ； the pivotal department

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