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[1]茹楠贾香平关瑜山吴华章孟朝琳.助推策略对低价值医疗行为干预效果的Meta分析[J].中国卫生质量管理,2024,31(11):30-34.[doi:10.13912/j.cnki.chqm.2024.31.11.07]
　RU Nan,JIA Xiangping,GUAN Yushan.Meta-Analysis of the Intervention Effect of Nudge Strategy on Low-Value Medical Behavior[J].Chinese Health Quality Management,2024,31(11):30-34.[doi:10.13912/j.cnki.chqm.2024.31.11.07]

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助推策略对低价值医疗行为干预效果的Meta分析

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 第31卷期数: 2024年11期页码: 30-34 栏目: 医疗质量出版日期: 2024-11-15

Title:: Meta-Analysis of the Intervention Effect of Nudge Strategy on Low-Value Medical Behavior

作者:: 茹楠贾香平关瑜山吴华章孟朝琳; 首都医科大学护理学院

Author(s):: RU Nan; JIA Xiangping; GUAN Yushan; School of Nursing,Capital Medical University

关键词:: 助推策略; 低价值医疗; 医护人员; Meta分析; 医疗质量

Keywords:: Nudge Strategy; Low-Value Care; Medical Staff; Meta-Analysis; Medical Quality

分类号:: 197.3

DOI:: 10.13912/j.cnki.chqm.2024.31.11.07

文献标志码:: A

摘要:: 目的评价助推策略对医护人员低价值医疗行为的干预效果，为低价值医疗行为治理提供循证依据。方法检索Cochrane Library、PubMed、Web of Science、CINAHL、Embase、中国知网、万方、维普等数据库建库至2023年12月1日收录的助推策略减少医护人员低价值医疗行为的随机对照试验。采用RevMan 5.4和Stata 16.0软件进行Meta分析。结果纳入8篇文献。助推策略可有效降低医护人员低价值医疗行为发生率（OR=0.60，95%CI［0.45，0.80］，P＜0.001）。其中，干预时间＜12个月、以医护人员为干预单元、多种联合的助推策略对低价值医疗行为的干预效果更佳，且助推策略对低价值抗生素处方和低价值影像学检查的干预效果差异具有统计学意义（P＜0.05）。结论助推策略对减少低价值医疗行为具有一定效果。我国学者可借鉴国外成功经验，通过本土化创新，探索出适合我国医疗卫生服务体系的针对不同类型低价值医疗行为的治理策略。

Abstract:: ObjectiveTo evaluate the intervention effect of nudge strategy on low-value medical behavior of medical staff, and to provide evidence-based basis for the governance of low-value medical behavior .MethodsCochrane Library, PubMed, Web of Science, CINAHL, Embase, CBM, CNKI, Wanfang, VIP and other databases were searched for randomized controlled trials on reducing low-value medical behavior of medical staff by nudge strategy from the establishment of the database to December 1, 2023. Meta-analysis was performed using RevMan 5.4 and Stata 16.0 software. ResultsA total of 8 articles were included. Nudge strategy could effectively reduce the incidence of low-value medical behavior of medical staff ( OR = 0.60, 95 % CI ［0.45, 0.80］,P< 0.001) .Among them, the intervention time < 12 months, the medical staff as the intervention unit, and a variety of combined nudge strategy had a better effect on reducing low-value medical behavior, and the difference in the intervention effect of the nudge strategy on low-value antibiotic prescriptions and low-value imaging examinations was statistically significant（P＜0.05）.Conclusion The nudge strategy has a certain effect on reducing low-value medical behavior. Chinese scholars can learn from the excellent experience of foreign countries and explore the governance strategies for different types of low-value medical service projects suitable for medical and health service system of China through localized innovation.

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更新日期/Last Update: 2024-11-15