Establishing evaluation standards for the preventive use of antimicrobial drugs in class Ⅰ incision orthopedic surgery and evaluating rationality and cost-effectiveness before and after volume-based procurement
WANG Jiangtao
YANG Liyue
SONG Junxing
SUN Qingsong
YE Ming
FANG Jia
HOU Ping
DING Boping
Abstract：Objective To establish evaluation criteria for the prophylactic use of antimicrobial drugs in Class Ⅰ inci-sion orthopedic surgeries and to assess the impact of volume-based procurement on the rationality and cost-effectiveness of such surgeries.Methods Evaluation criteria were developed based on the Guidelines for Clinical Use of Antimicrobial A-gents(2015 Edition),drug information leaflets,clinical guidelines,and expert consensus.Using the implementation of volume-based procurement of antimicrobials in October 2021 as a reference point,data from 270 archived cases of Class I inci-sion orthopedic surgeries at a tertiary hospital in Anhui Province,spanning May 2019 to February 2024,were analyzed.These cases included 135 surgeries each from periods before and after the implementation of the procurement policy,and data were analyzed using the weighted TOPSIS(Technique for Order Preference by Similarity to Ideal Solution)method.Results The indicators with the highest weighting were appropriateness of indication,drug selection,timing of administration(preoperative,intraoperative,postoperative),and cost-effectiveness of selected drugs,with respective weights of 0.181,0.170,0.144,0.076,0.072,and 0.066.Post-policy implementation,the average cost of antimicrobials per case decreased by 77.67％.Rational drug use increased significantly from 70.37％(Ci ≥0.6)before to 84.45％(Ci ≥ 0.6)after volume-based procurement,with statistical significance(P＜0.05).Conclusion The weighted TOPSIS method is a feasible approach for e-valuating the rationality and cost-effectiveness of prophylactic antimicrobial use in class 1 incision orthopedic surgeries.Volume-based procurement not only reduces patient medication costs but also indirectly improves the rationality of drug use.Hospitals should strengthen oversight of irrational drug use to promote rational clinical prescribing practices.
Keywords：Volume based procurement of drugsAntibioticsOrthopedic class Ⅰ incision surgeryWeighted TOPSIS method
Publication Date：2025-01-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 89-93,104 )