RESUMEN
In order to standardize the review and comment of national key monitoring drug prescriptions （medical orders） by medical institutions at all levels， the Sichuan Academy of Medical Sciences·Sichuan Provincial People’s Hospital took the lead in compiling the Review and Comment Rules of National Key Monitoring Drugs prescriptions （Medical Orders） herein after referred to as the Rules in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as the List） issued by the National Health Commission confirmed in Jan. 13， 2023. According to the laws and drug instructions issued by the national drug regulatory department， clinical guidelines and expert consensus， combined with the actual situation of patients （including age， body weight， liver and kidney function）， the writing group classified the common and unreasonable drug use problems for 30 kinds of drugs included in the List and develop the review and comment details. After two rounds of Delphi method questionnaire research and experts’ online meetings， and reviewed by the steering committee， the final Rules was formed. The Rules aim to provide reference for the evaluation of the rational use of drugs included in the List by medical institutions， so as to realize the standardized management of key monitoring drugs， promote the rational drug use in medical institutions， and ensure the safety of drug use for patients.
RESUMEN
Objective:This paper makes a comprehensive evaluation on the columns of Chinese Pediatric Emergency Medicine from communication effect and citation effect, and analyzes the advantages and disadvantages of each column setting, so as to provide evidence-based basis for journal soliciting contributions, and guide column selection planning.Methods:The communication index (website browsing frequency, website download frequency, Wanfang download frequency) and citation index (citation frequency, zero citation rate, high citation rate, high citation rate ratio) of columns in Chinese Pediatric Emergency Medicine from 2016 to 2018 were counted, and whether there were statistical differences among the evaluation indexes of columns was analyzed.Results:In terms of communication index: among the top 20 column communication indicators, comments and guidance columns account for a very high proportion; The communication index of comment column and guidance column was significantly higher than that of other columns, and the differences were statistically significant; There was no significant difference between Article column and Clinical application research column.In terms of citation index: the citation frequency and high citation rate of the Article column are the highest, while the zero citation rate is the lowest, and there was no significant difference among the four columns of Expert forum, Clinical application research, Review and Guideline·consensus·interpretation; The high citation rate ratio of the Guideline·consensus·interpretation column is the highest, followed by the Article column, and the two columns are significantly higher than the Expert forum column; Among the top 20 papers with the highest citation frequency, the column of treatise accounts for 65%.Conclusion:Expert forum column and Guidelin·consensus·interpretation column are the key to influence the communication effect of journals.Article column and Guidelin·consensus·interpretation column are the key to influence the citation effect of journals.The absolute value of evaluation index can not scientifically evaluate the academic quality of journals.
RESUMEN
OBJECTIVE：To conduct the prescri ption comment of Chinese patent medicine based on self-developed rational drug use system and evaluate its effect ，and to promote rational use of Chinese patent medicine. METHODS ：The self-developed rational drug use system was used to evaluate the complete prescriptions and classified special prescriptions of Chinese patent medicines in our hospital from Jan. to Jun. 2019（before implementation ）and from Jan. to Jun. 2020（after implementation ）； combined with pharmacists ’manual comments ，the situation of irrational drug use in the two periods was compared ，and the effect of prescription comment by rational drug use system was evaluated. RESULTS ：Results of full prescription comment of Chinese patent medicine in our hospital showed that the unqualified rate of Chinese patent medicine prescriptions was 1.5％，which was significantly lower than 5.6％ before the implementation （P＜0.05）. Results of special prescription comment of Chinese patent medicine showed that the unqualified rates of TCM injection ，toxic Chinese patent medicines and emergency Chinese patent medicines were 11.8％，10.7％，11.0％ before implementation ；while after implementation ，they were 3.6％，4.2％ and 6.6％， which were significantly lower than before implementation （P＜0.05）. CONCLUSIONS ：Self-developed rational drug use system of Chinese patent medicine shows remarkable effect on full prescription comment and special comment ，which greatly improves the level of rational drug use of Chinese patent medicines in our hospital.
RESUMEN
Resumo Com as contrarreformas trabalhistas em curso no Brasil, o trabalho retoma sua centralidade. Nesse contexto, no que se refere ao setor de saúde, a bioética pode ser uma aliada para compreender limites e possibilidades do atual cenário social. Assim, este estudo analisa criticamente a interface entre bioética, saúde e trabalho, pensando sua atualidade como tema de pesquisa. Optou-se pelo formato ensaístico-reflexivo, com texto em três partes. A primeira trata do trabalho em saúde e de seus predicados éticos; a segunda apresenta mais diretamente a relação entre esse trabalho e a bioética, detendo-se sobre a questão do desempenho; e a terceira resgata a raiz da relação bioética-trabalho por meio da crítica à moral e à forma jurídica enraizadas no modo de produção capitalista. Por fim, lança-se brevíssima sugestão sobre como pautar este tema criticamente, de modo a ampliar seu escopo.
Abstract With the current Brazilian labor counter-reforms, the topic becomes more present in political discussions. In this context, bioethics can help to understand the limits and possibilities of the current social scenario. Thus, this study analyzes the interface between bioethics, healthcare and work, as well as its relevance as a research topic. We chose the reflexive essay format and divided the text into three parts. The first addresses the work in healthcare and its ethical aspects, the second presents the relation between bioethics and this type of work considering mainly its performance, and the third addresses the bioethical-work relationship through the criticism of morals and the laws in capitalism. Finally, we make a brief suggestion on how to base this topic from the point of view of expanding its scope from a critical perspective.
Resumen Con las contrarreformas laborales en marcha en Brasil, el trabajo retoma su centralidad. En ese contexto, en lo que se refiere al sector de salud, la bioética puede ser una aliada para comprender límites y posibilidades del actual escenario social. Así, este estudio analiza críticamente la interfaz bioética, salud y trabajo, pensando su actualidad como tema de investigación. Se optó por un formato ensayístico-reflexivo dividido en tres partes. La primera trata del trabajo en salud y sus predicados éticos; la segunda presenta más directamente la relación entre ese trabajo y la bioética, deteniéndose en la cuestión del desempeño; y la tercera rescata la raíz de la relación bioética-trabajo mediante una crítica a la moral y a la forma jurídica enraizadas en el modo de producción capitalista. Finalmente, se hace una brevísima sugerencia sobre cómo basar este tema para ampliar su alcance desde una perspectiva crítica.
Asunto(s)
Trabajo , Bioética , Salud , Derechos Civiles , ÉticaRESUMEN
This paper introduced European Guidelines for Physiotherapy of Parkinson's Disease, especially the form, content and selection, to give a reference of evidence-based practice in China.
RESUMEN
OBJECTIVE: To explore the application effect of quality control circle management in improving the qualified rate of anesthetic drugs prescription in hospital. METHODS: The quality control circle was established to explore the causes of the unqualified anesthetic drugs prescription in our hospital by using the 80/20 rule and fish-bone diagram. The measures to improve the prescription pass rate were determined, and the changes of the prescription pass rate before and after QCC management were compared through the implementation and review of the measures. RESULTS: Using the management of quality control circle, the prescription quality of inpatient anesthetic drugs was significantly improved in our hospital in 2018 and the qualified rate increased from 70.07% in 2017 to 2018 97.78% above target value of 6.69%. After continuous quality control circle management, the qualified rate of prescription increased to 99.33% in the first three quarters of 2019. CONCLUSION: The development of QCC can effectively improve the qualified rate of anesthetic drugs prescription in hospital, not only standardizing the use of anesthetic drugs, promoting drug safety of patients, but also improving the comprehensive quality of pharmacists and the quality of hospital pharmaceutical care.
RESUMEN
OBJECTIVE： To investigate pharmaceutical care of cancer pain therapy in medical institutions from Beijing area， and to provide reference for improving the quality of pharmaceutical care for cancer pain in medical institutions and formulating cancer pain therapy decision by public health administration departments at different levels. METHODS： Inspection results of standardized diagnosis and treatment for cancer pain were analyzed retrospectively in Beijing Pain Therapy Quality Control and Improvement Center during Feb.-Mar. 2018. Scoring results of pharmaceutical care （20 points） and its 5 sub-items （personnel participation， drug supply， drug management， outpatient prescription comment and inpatient prescription comment， 4 points each item） were analyzed statistically and classified according to hospital level and pharmaceutical care inspection results. RESULTS： A total of 64 hospitals in Beijing participated in the inspection， including 27 tertiary A hospitals （42.19％）， 21 tertiary B hospitals （32.81％）， 16 secondary hospitals or first-level hospitals （25.00％）. Pharmaceutical care in all hospitals met the inspection requirements with qualified rate of 100％. 52 hospitals performed excellently （81.25％）， and 12 hospitals were qualified for pharmaceutical care （18.75％）. Among 5 sub-items of personnel participation， drug supply， drug management， outpatient prescription comment and inpatient prescription comment， the average score of drug supply item was the highest （3.83±0.05）； the lowest was the personnel participation item （2.93±0.13）. The results of pharmaceutical care inspection in tertiary A hospitals （17.80±0.28） and tertiary B hospitals （17.78±0.30） were significantly better than those in secondary hospitals or first-level hospitals（16.16±0.50）（P＜0.01 or P＜0.05）； there was statistical significance only in the score of outpatient prescription comment among 5 sub-items（P＝0.026）. Total scores of the hospitals with excellent pharmaceutical care were significantly higher than those of the hospitals with qualified pharmaceutical care in terms of personnel participation， outpatient prescription comment and inpatient prescription comment （P＜0.01 or P＜0.05）. There was significant difference in the inspection results of pharmaceutical care among the excellent group， the qualified group and the unqualified group classified by the results of personnel participation item （P＜0.01 or P＜0.05）. CONCLUSIONS： The quality of pharmaceutical care for cancer pain therapy in medical institutions from Beijing area has reached the qualified level， but the participation of clinical pharmacists in cancer pain therapy and outpatient prescription comment still need improvement in further. The training of clinical pharmacists and information construction of narcotic drug management should be strengthened so as to improve the overall quality of pharmaceutical care for cancer pain.
RESUMEN
Objective To retrospectively analyze the implementation of the antimicrobial agents prescription monthly review at the emergency and outpatient departments for the past five years, for evaluation of its action in promoting rational application of antimicrobial drugs. Methods At the baseline investigation stage, 1780 prescriptions on antibiotics in emergency and outpatient department from June 2012 to November 2012 were randomly selected for centralized evaluation. The period of correction and observation falls into two stages. The first stage ranged from December 2012 to February 2015, when the prescription of antibiotics was sampled manually for monthly review. The second stage ranged from March 2015 to June 2017, when a prescription review software for prescription comment was introduced for the sample purpose. The data so acquired were subject to chi-square test and linear regression analysis using Excel 2010 and SPSS 16. 0. Results The rational rate of prescription for antibiotics at the emergency department increased from 80. 56％ of the baseline stage to 99. 47％ of the second stage (166506/167400), scoring a difference of statistical significance (P<0. 001). With intervention of the prescription review software, the percentage of irrational use of antimicrobial agents dropped by 5. 18％ compared to the baseline stage. Conclusions Monthly prescription review on antimicrobial agents at the outpatient and emergency departments could promote the rational use of antimicrobial agents and play an important role in clinical drug safety. Information system and performance assessment contributed to the effect of prescription review.
RESUMEN
OBJECTIVE:To provide reference for promoting the rational use of Dexamethasone sodium phosphate injection in the clinic. METHODS:Special comment criteria and evaluation rules was formulated,medical records of 1273 inpatients receiving Dexamethasone sodium phosphate injection were collected from our hospital during Jul. 2014-Jun. 2015. Rationality of drug use was evaluated and analyzed retrospectively. RESULTS:The most use amount and case number of Dexamethasone sodium phosphate injection were in the departments of blood/oncology,obstetrics,emergency minimally invasive surgery,gastrointestinal surgery,emergency trauma of orthopedics and thyroid breast surgery;while much less were in departments of new pediatrics, infection and rehabilitation. There were 138 cases of irrational use of Dexamethasone sodium phosphate injection found in special comment, and the total irrational use rate was 10.84％ . The types of irrational use included inappropriate indication (contraindication,59.42％),inappropriate drug combination(18.84％),inappropriate drug selection (15.94％),inappropriate usage and dosage(3.62％)and inappropriate drug dosage forms or drug delivery methods(2.17％),etc. The irrational use rate of Dexamethasone sodium phosphate injection monthly declined steadily by month from 30.35％ in Jul. 2014 to 7.81％ in Jun. 2015 through the special comment;then a consensus of 5 points for the drug use formed in our hospital. CONCLUSIONS:There are irrational situations in the clinical use of Dexamethasone sodium phosphate injection in our hospital,especially in the cases of inappropriate indications. The rationality of the drug can be improved by the development of the special comment. This work should continue to be carried out in the future and perfected.
RESUMEN
OBJECTIVE:To explore new method of prescription comment in medical institutions of Chongqing under the background of"New Medical Reform",and to provide reference for prescription comment innovation and promoting rational drug use in clinic. METHODS:Through analyzing policy background of prescription comment innovation and practice,referring to experience of other regions,the achievements and problems were analyzed by developing centralized prescription comment and prescription comment information construction in municipal and regional (county-level) medical institutions of Chongqing. The countermeasures suggestion was put forward. RESULTS&CONCLUSIONS:The prescriptions of 16 municipal medical institutions were commented centrally,involving more than 300 medical records and 1600 prescriptions or medical orders. The prescriptions of 135 regional (county-level) medical institutions were commented centrally,involving more than 3100 medical records and 12100 prescriptions or medical orders."Chongqing Medical Institution Prescription Comment Key Technology Monitoring System"was established. Above measures innovated centralized prescription comment mode,improved the quality of prescription comment and promoted prescription comment informatization. There were still problems as incomplete coverage of the system,inspection to become a mere formality. It is suggested to strengthen internal quality control of medical institutions by establishing rational drug use scoring management system,developing clinical pharmacist ward round and prescription checking in advance;establish and improve third-party external comment and supervision mechanism;improve the knowledge of prescriptions comment staff in all directions so as to further standardize prescriptions and promote rational drug use in medical institutions.
RESUMEN
OBJECTIVE: To evaluate the effects of special prescription comment model intervention on prophylactic application of antibiotics during perioperative period of clean operation in our hospital. METHODS: By founding specialist group and prescription comment group, formulating unified form for evaluating prophylactic application of antibiotics during perioperative period of clean operation, establishing comment criteria referring to Guidelines for Clinical Antibiotics Use (2015 edition), Notice on Further Strengthening the Management of Clinical Antibiotics Use, drug package inserts and so on; havivg the aid of administrative intervention and quality assessment, The special prescription comment model was established. Based on stratified sampling (according to the clinical departments, kind of procedure), Each 180 medical records were collected from our hospital during Jan. -Jun. 2015 (before intervention) and Jan. -Jun. 2016 (after intervention). The unified form for perioperative period of clean operation was formulated to comment each medical record in respects of prophylactic utilization rate of antibiotics, medication indication, medication timing, drug selection, usage and dosage, medication course, drug combination, etc. RESULTS: After the following intervention measures were adopted, such as The prophylactic utilization rate of antibiotics of our hospital during perioperative period of clean operation decreased from 96. 7％ before intervention to 25. 0％ after intervention (P< 0. 05). The rates of drug use without indication, irrational medication timing before surgery, irrational drug selection, irrational usage and dosage, irrational medication course and irrational drug combination were decreased from 71. 3％, 72. 4％, 65. 5％, 23. 0％, 97. 1％, 17. 8％ before intervention to 4. 4％, 0, 8. 9％, 11. 1％, 22. 2％, 0 after intervention (P<0. 05) respectively. Before intervention, 8 categories 20 kinds of antibiotics were used prophylactically in our hospital during perioperative period of clean operation; 86 patients used 2 kinds of or more antibiotics, among which there were 31 cases of drug combination and 55 cases of drug replacement. After intervention, 3 categories 4 kinds of antibiotics were used prophylactically in our hospital during perioperative period of clean operation; there was no drug combination and drug replacement. CONCLUSIONS: Special prescription comment model can obviously improve rational use of antibiotics during perioperative period of clean operation.
RESUMEN
Objective: To establish the rational drug use standard for elderly hypertensive patients after comprehensive assessment, so as to provide evidence for rational drug use in clinics. Methods: Such standards as Beers, STOPP and START were summarized, key items were extracted,duplicate contents were deleted,and the initial standard was formed and used as the first round questionnaire. The Delphi method was used to conduct the second round expert consultation questionnaire,and the positive coefficients, authority and coordination degree of the experts were evaluated. Results: A total of 10 experts participated in the consultation, and the effective re-covery rate of the second round was 100% and the average authority coefficient was 0. 88. The coordination coefficient of the two rounds was 0. 57 and 0. 76, respectively. The standard of rational drug use for the elderly patients with hypertension after comprehensive as-sessment was finally completed. The standard contained 13 comprehensive assessment contents and 21 drug warning entries. Conclu-sion: After 2 rounds of expert consultation,the opinions tend to be uniform with high degree of coordination. The standard can provide reference for clinicians and clinical pharmacists to use drugs rationally. At the same time,it also provides ideas for the establishment of rational drug use standards for other diseases.
RESUMEN
Objective: To analyze the prescriptions of analgesic drugs for the patients with cancer pain, and promote the rational use of narcotic and analgesic prescriptions. Methods: Using the PCNE classification system, the list of all drug-related problems (DRPs) from 115 patients admitted to the standardized treatment of cancer pain from January to December 2017 was analyzed. Re-sults: In our hospital from January to December 2017, there were 52 cases of prescribed DRPs for narcotic and analgesic drugs in the standardized treatment of cancer pain with the incidence of 45. 22% . DRPs mainly focused on treatment safety with the incidence of 72. 31% . The drug choice caused the highest incidence of DRPs accounting for 63. 24% , followed by dose selection accounting for 20. 59% . Conclusion: There are still unreasonable prescriptions of narcotic analgesia in our hospital. According to the PCNE classifi-cation system, it is necessary to strengthen the communication with clinicians, carry out education for the patients with cancer pain, and further educate pharmacy staff on the knowledge of analgesic drugs. Through the above measures, the regulation of prescription medication for narcotic analgesics can be intensified.
RESUMEN
With the growth of number of Chinese patent medicines and clinical use, the rational use of Chinese medicine is becoming more and more serious. Due to the complexity of Chinese medicine theory and the uncertainty of clinical application, the prescription review of Chinese patent medicine always relied on experience in their respective, leading to the uncontrolled of clinical rational use. According to the traditional Chinese medicine (TCM) theory and characteristics of the unique clinical therapeutics, based on the practice experience and expertise comments, our paper formed the expert consensus on the prescription review of Chinese traditional patent medicine for promoting the rational use of drugs in Beijing. The objective, methods and key points of prescription review of Chinese patent medicine, were included in this expert consensus, in order to regulate the behavior of prescription and promote rational drug use.
RESUMEN
Objective To analyze the unreasonable prescription of the discharged drug and to propose the intervention measures to further improve the rationality of the prescription.Methods 18 506 pieces of hospital discharge prescriptions were collected,and the above prescriptions were commented by the prescription review working group.The classified items and their constituent ratios of irrational prescriptions for discharge were statistically analyzed.Results The irrational prescription of this study was 402 pieces,and the unreasonable prescription rate was 2.17%.Of which 321 pieces were not standardized prescriptions, accounting for 79.85%, 81 pieces for the inappropriate prescriptions, accounting for 20.15%.321 pieces of non-standard prescription, doctors do not regulate the signature and seal up 74 pieces, accounting for 23.05%,drug dosage, specification, number of errors69 pieces,21.50%,the third allergy test does not indicate53 pieces,accounting for 16.51%;81 pieces inappropriate medication prescription, usage of the drug, did not suitable for most,51 pieces,62.96%,followed by not suitable for combination 22 pieces, accounted for27.16%.Conclusion Through the prescription review, the discharge of drug irrational prescription analysis, and strengthen exchanges with clinical departments can promote the clinical rational drug use, improve the safety of clinical medication.
RESUMEN
OBJECTIVE:To provide reference for drug registration declaration. METHODS:The disapproval comments of Chi-na Food and Drug Administration on the declared drugs in Guangdong Province in 2015 were collected,existing problems in cur-rent drug registration declaration in clinical trials stage and registered production stage were analyzed. And suggestions were put for-ward based on relevant policies and regulations. RESULTS & CONCLUSIONS:Reasons for the rejection of declaring chemical drugs in clinical trials stage mainly focused on that there had been imported drugs applied for registration or new drugs entering monitoring period. While pharmacy research quality defects,especially insufficient research in impurities and relevant materials, are the main problems of declaring clinical trials and production. In terms of clinical trail declaration,applicant should respond to new drug registration classification reform,strengthen original innovation development;the development of biological products should establish comprehensive and effective evaluation system to form superior technology and products. In terms of drug registra-tion production declaration,related departments or drug manufacturers should enhance the evaluation for drug form and specifica-tions design,and generic drugs should pay attention to the consistency evaluation with the original research drugs. Besides,the above problems can be solved by conducting scientific and feasible research methods for impurities and related material,and pay at-tention to enlarging research of forward-looking production technology.
RESUMEN
OBJECTIVE:To provide scientific reference for prescription comment. METHODS:Network questionnaire was de-signed to investigate the development of hospital prescription comment taking hospital pharmacists from Shanghai as the object. The surveyed data were analyzed statistically. RESULTS:A total of 51 effective questionnaires were collected with effective recovery rate of 100%,involving 51 hospitals. Second-level prescription comment mode was adopted in 51 hospitals;the mode of"initial clinical pharmacist comment,expert group re-comment"was mostly adopted in second-level hospitals,accounting for 23.53%. The mode of"outpatient pharmacist initial comment,clinical pharmacist re-comment"was mostly adopted in third-level hospitals and general hospitals,accounting for 23.53% and 21.57%,respectively. The method of"all prescriptions randomly selected at one stage"was mostly adopted in third-level hospital(accounting 23.53%). 45.10% of them did not adopt information system for pre-scription comment. 86.27% of surveyed hospitals carried out the review once a month. The limitation on the amount of drugs which were"less than 2 weeks"and"less than 1 month"took up the high proportion(41.18%,45.10%). Among irrational used common drugs,antibiotics accounted for the highest proportion (43.14%). In supernormal prescriptions,the most common problem was drug use without indication(accounting for 64.71%). Surveyed pharmacists from different types of hospital had different comments on same prescription. The effects of prescription comment on hospital rational drug use and pharmacist's ability had been widely recognized,but its effects on physician prescribing behavior was not satisfactory(only 5.88% respondents believed the great effects of prescription comment). Main ideas and suggestions of surveyed pharmacists for improving the role of prescription comment were"to improve the comment ability of pharmacists","to pay more attention by hospital leaders"and"to increase the degree of infor-mation management". CONCLUSIONS:During the process of prescription comment,it is necessary to improve the authority of prescription comment and the scientific sampling method,optimize the frequency of prescription comment and the consistency of comment results,and also pay attention to combination with administrative intervention.
RESUMEN
OBJECTIVE: To establish the criteria in repeated usage of traditional Chinese patent medicines. METHODS: Fifteen experts were invited to take a two-rounded questionnaire survey. Experts' positive coefficients, authority coefficient, reliability, concentration degree and coordination degree towards experts' opinions were calculated by SPSS23.0 after integrating the opinions. The criteria were modified based on the prespecified principles. RESULTS: In this two-rounded survey, experts' positive coefficients were 100.00% and 93.33%, averaging authority coefficient was 0.91, reliability of two rounds were 0.87 and 0.82. Coordination degree increased from 0.36 (P<0.01) to 0.46 (P<0.01). Three first level index and eighteen second level index were included in this cirteria. CONCLUSION: With well response, authority, reliability and coordination, this study could define preliminary evaluation criteria of repeated traditional Chinese patent medicines.
RESUMEN
Objective:To investigate the clinical application of fibrinogen (FIB) in a certain hospital to enhance the rational use in clinics.Methods:A retrospective investigation was adopted to analyze the clinical application of FIB in a certain hospital in 2016. Results:Totally 489 inpatients were treated with FIB in 2016,and among them,243 cases were surgery patients and another 246 ones were non-surgery patients. The main involved departments were cardiovascular surgery,cardiovascular medicine,emergency,intensive medicine,gynaecology and obstetrics, gastroenterology and neurosurgery. The rationality of indication was 80.0% (391/489), and the non-indication use mainly existed in cardiovascular surgery and cardiovascular medicine departments. Among the 391 cases with in-dication,3 cases were with improper compatibility,17 cases with low dosage, and the irrationality of usage and dosage was 17.9% (20/391). Conclusion:The clinical application of FIB is basically rational in the hospital,while non-indication use still exists during the perioperative period in cardiovascular and cerebrovascular surgery,and nonstandard usage and dosage appear in clinics from time to time. The prescription comment on blood products such as FIB should be enhanced in order to improve the rational use in clinics.
RESUMEN
Objective:Based on the unreasonable structure,fragmentization and insufficient resources of medical and health service system in China,the literature review was conducted on the analysis of integrated medical and health service system.Methods:It sorted out and analyzed the existing related literature in the academic field.Results:The integrated health system was developed by their elements and methods,which lacked the evaluation and analysis on the responsibility among different stake holders and effects after the integration.Conclusion:Further research should be developed into the implementation of dual referral based on integrated health system;the responsibility relationship among different stakeholders in the integration progress,the integration and optimization of medical and health service system under the background of Internet+,etc.