背景:抗菌素耐药性(AMR),尤其是耐碳青霉烯类铜绿假单胞菌(CRPA),导致发病率严重上升,死亡率和成本。医疗专业人员在遏制AMR方面发挥着重要作用。先前的研究忽略了工作量对医疗专业人员与AMR之间关系的影响。本研究旨在探讨医务人员与CRPA率之间的关系以及医务人员工作量对这种关系的调节作用。
方法:构建2014-2017年省级面板数据集。医疗专业人员是由医生的数量来衡量的,注册护士,药剂师,和临床微生物学家每1000人。工作量是通过每日医师就诊次数来衡量的。采用固定效应模型和层次回归分析探讨工作量对医务人员和CRPA率的调节作用。
结果:医生的数量,注册护士,药剂师和临床技术人员与CRPA率显着负相关(coef。=-0.889、-0.775、-1.176和-0.822;P分别=0.003、0.003、0.011和0.007)。工作量对医生有显著的积极调节作用,注册护士,药剂师,临床技术人员和CRPA率(系数。=1.270、1.400、2.210和1.634;P分别为0.004、0.001、0.035和0.003)。
结论:增加医疗专业人员的数量可能有助于抑制CRPA率。应实施旨在减少医疗专业人员工作量的措施,以进一步提高CRPA绩效。
BACKGROUND: Antimicrobial resistance (AMR), especially carbapenem-resistant Pseudomonas aeruginosa (CRPA), causes a serious increase in morbidity, mortality and costs. Medical professionals play an important role in curbing AMR. Previous studies overlooked the impact of workload on the relationship between medical professionals and AMR. This study aimed to explore the relationship between medical professionals and the CRPA rate as well as the moderating effect of medical professionals\' workload on this relationship.
METHODS: A provincial-level panel dataset from 2014 to 2017 was constructed. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, and clinical microbiologists per 1000 population. Workload was measured by the number of daily physician visits. Fixed effect model and hierarchical regression analysis were performed to explore the moderating effect of workload on medical professionals and the CRPA rate.
RESULTS: The numbers of physicians, registered nurses, pharmacists and clinical technicians were significantly negative associated with the CRPA rate (coef. = - 0.889, - 0.775, - 1.176, and - 0.822; P = 0.003, 0.003, 0.011, and 0.007, respectively). Workload had a significant and positive moderating effect on physicians, registered nurses, pharmacists, clinical technicians and the CRPA rate (coef. = 1.270, 1.400, 2.210, and 1.634; P = 0.004, 0.001, 0.035, and 0.003, respectively).
CONCLUSIONS: Increasing the number of medical professionals may help curb the CRPA rate. Measures aimed at reducing medical professionals\' workload should be implemented to further improve CRPA performance.