Prescribing Patterns in Outpatient Clinics of Township Hospitals in China: A Comparative Study before and after the 2009 Health System Reform

Ding Ding, Qingxia Pan, Linghan Shan, Chaojie Liu, Lijun Gao, Yanhua Hao, Jian Song, Ning Ning, Yu Cui, Ye Li, Xinye Qi, Chao Liang, Qunhong Wu and Guoxiang Liu
Additional contact information
Ding Ding: School of Health Management, Harbin Medical University, Harbin 150000, China
Qingxia Pan: School of Health Management, Harbin Medical University, Harbin 150000, China
Linghan Shan: School of Health Management, Harbin Medical University, Harbin 150000, China
Chaojie Liu: School of Psychology and Public Health, La Trobe University, Bundoora 3086, Australia
Lijun Gao: School of Health Management, Harbin Medical University, Harbin 150000, China
Yanhua Hao: School of Health Management, Harbin Medical University, Harbin 150000, China
Jian Song: The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
Ning Ning: School of Health Management, Harbin Medical University, Harbin 150000, China
Yu Cui: School of Health Management, Harbin Medical University, Harbin 150000, China
Ye Li: School of Health Management, Harbin Medical University, Harbin 150000, China
Xinye Qi: School of Health Management, Harbin Medical University, Harbin 150000, China
Chao Liang: School of Health Management, Harbin Medical University, Harbin 150000, China
Qunhong Wu: School of Health Management, Harbin Medical University, Harbin 150000, China
Guoxiang Liu: School of Health Management, Harbin Medical University, Harbin 150000, China

IJERPH, 2016, vol. 13, issue 7, 1-10

Abstract: Objective: China introduced a series of health reforms in 2009, including a national essential medicines policy and a medical insurance system for primary care institutions. This study aimed to determine the changing prescribing patterns associated with those reforms in township hospitals. Methods: A multi-stage stratified random cluster sampling method was adopted to identify 29 township hospitals from six counties in three provinces. A total of 2899 prescriptions were collected from the participating township hospitals using a systematic random sampling strategy. Seven prescribing indicators were calculated and compared between 2008 and 2013, assessing use of medicines (antibiotics and adrenal corticosteroids) and polypharmacy, administration route of medicines (injections), and affordability of medicines. Results: Significant changes in prescribing patterns were found. The average number of medicines and costs per-prescription dropped by about 50%. The percentage of prescriptions requiring antibiotics declined from 54% to 38%. The percentage of prescriptions requiring adrenal corticosteroid declined from 14% to 4%. The percentage of prescriptions requiring injections declined from 54% to 25%. Despite similar changing patterns, significant regional differences were observed. Conclusions: Significant changes in prescribing patterns are evident in township hospitals in China. Overprescription of antibiotics, injections and adrenal corticosteroids has been reduced. However, salient regional disparities still exist. Further studies are needed to determine potential shifts in the risk of the inappropriate use of medicines from primary care settings to metropolitan hospitals.

Keywords: antibiotics; prescribing pattern; township hospitals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
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