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首页> 外文期刊>British journal of clinical pharmacology >The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities
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The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

机译：高校医院用药对其周边社区药品消费的影响

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To investigate the influence of hospital drug choices on pharmaceutical consumption for nine competitive classes in the surrounding community.MethodsEcological study. Data from the national survey on drugs in hospitals were used to extract quantities purchased by 25 French university hospitals for three ‘hospital classes’ (EPOs, LMWHs and setrons) and six ‘ambulatory classes’ (PPIs, ACEIs and ARBs, statins, -adrenoreceptor antagonists (AAAs) and selective serotonin re-uptake inhibitors SSRIs). Re-imbursed quantities for patients living in the hospital's catchment area were extracted from the national health insurance database. The relationship between the use of a brand in hospitals and their catchment areas was assessed using multivariate linear regressions with instrumental variables.ResultsAn increase of 1 day of treatment with one brand in the hospital was associated with a significant increase of 2.8 days of treatment with the same brand in the catchment area. However, results strongly varied according to classes. An increase of 1 day of treatment in the hospital was significantly associated with an increase of 0.21 day for ‘hospital classes’ and 21.8 days for ‘ambulatory classes’ in the catchment area. Strong variations were seen across ‘ambulatory classes’. The effect was maximal for cardiovascular classes and not significant for AAAs and SSRIs. The size of the effect also varied with hospital characteristics: small and proximity university hospitals exerted the greatest influence.ConclusionsHospital consumption influences the use of drugs in the community. A significant effect was found, especially for competitive classes used on a long-term basis. The economic consequences of these findings need to be addressed.
机译：调查医院药物选择对周围社区9个竞争类的药物消耗的影响。方法生态学研究。来自全国医院药物调查的数据用于提取25家法国大学医院购买的三种“医院类别”（EPO，LMWH和Setron）和六种“门诊类别”（PPI，ACEI和ARB，他汀类药物，-肾上腺素受体）购买的数量拮抗剂（AAAs）和选择性5-羟色胺再摄取抑制剂（SSRI）。从国家健康保险数据库中提取了居住在医院服务区的患者的报销额。通过使用带有工具变量的多元线性回归来评估品牌在医院及其服务区域之间的关系。结果在一家医院中使用一个品牌治疗1天的增加与使用该品牌治疗的2.8天的显着增加有关。汇水区的同一品牌。但是，结果因类别而异。医院治疗1天的增加与集水区“医院班”的0.21天和“门诊班”的21.8天显着相关。在“门诊课程”中看到了很大的差异。对于心血管疾病类别，这种作用最大，而对于AAA和SSRI，作用不明显。效果的大小也随医院的特点而变化：小型和邻近大学医院的影响最大。结论医院消费影响社区的药物使用。发现了显着的效果，特别是对于长期使用的竞争类。这些发现的经济后果需要加以解决。

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