探討抗生素監控資訊系統對醫師開藥行為意圖之影響

The impact of physicians’ antibiotic prescribing behavior intention using antibiotic stewardship information system

在醫院管理中，抗生素的管理為病人安全及醫療品質之重要基礎。台灣數位政府排名屢佔世界前茅，醫療資訊系統亦為他國學習之對象，然而我國醫院未來有望以優勢之醫療系統輔助其醫院的管理。由於近幾年抗生素濫用在世界各國已受到高度關注，世界衛生組織在2011年將世界健康日的主題，訂定為全球降低抗生素的濫用以抑止抗藥性。各國遂紛紛擬定相關措施以減少抗生素濫用，研究指出管理方法中以事前審核及電腦輔助系統較有效果。因此本研究將運用抗生素監控資訊系統，針對醫師探討抗生素監控資訊系統對其開立抗生素行為的影響。理論基礎將採被應用於探討歐洲七國之醫師開藥行為的計畫行為理論，再根據文獻探討進行研究模式之修正。本研究結果可加強計畫行為理論解釋醫師使用抗生素監控資訊系統開藥行為之完整性，提高醫生應用資訊系統遵循開立抗生素規範，作為醫院管理之基礎並提升病人的安全與醫療品質。

In hospital management, antibiotic stewardship happens to be one of the most important foundations for patient safety and medical care quality. Taiwan’s e-government has been ranked among worldwide tops for years, and healthcare professionals from many foreign countries came to Taiwan to study and learn from our hospital information systems. Moreover, our hospitals are also willing and expecting to assist overseas hospitals in need with our superiority of hospital information systems in the future. Recently, misuse of antibiotics has become a serious worldwide issue. World Health Organization (WHO) even chose antimicrobial resistance and its global spread as the main theme for the world health day in 2011. Many countries established policies and mechanism to control the abuse of antimicrobial resistance. Studies undertaken showed that auditing prescription beforehand and using computer-aided systems are more effective methods. Therefore, this study was to explore the impact on physicians’ prescribing behavior by using the antibiotic stewardship information system. The theoretic foundation of this research model was Theory of Planned Behavior (TPB) which had been used to study the physicians’ prescribing behavior in Europe. The research model was modified by adding other variables through related literature reviews. The results of this study can be used to increase the explanation of TPB completeness, to understand the influence on physicians’ obedience of prescribing antibiotics by utilizing the antibiotic stewardship information system as an effect tool to further prevent antimicrobial resistance from getting worse, and to build an more solid basis for hospital management to enhance patients’ safety and medical care quality.