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Int. J. Environ. Res. Public Health 2016, 13(7), 679; doi:10.3390/ijerph13070679

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

1
School of Health Management, Harbin Medical University, Harbin 150000, China
2
School of Psychology and Public Health, La Trobe University, Bundoora 3086, Australia
3
The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
These authors contributed equally to this work.
*
Authors to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 31 May 2016 / Revised: 29 June 2016 / Accepted: 30 June 2016 / Published: 5 July 2016
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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. View Full-Text
Keywords: antibiotics; prescribing pattern; township hospitals antibiotics; prescribing pattern; township hospitals
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Ding, D.; Pan, Q.; Shan, L.; Liu, C.; Gao, L.; Hao, Y.; Song, J.; Ning, N.; Cui, Y.; Li, Y.; Qi, X.; Liang, C.; Wu, Q.; Liu, G. Prescribing Patterns in Outpatient Clinics of Township Hospitals in China: A Comparative Study before and after the 2009 Health System Reform. Int. J. Environ. Res. Public Health 2016, 13, 679.

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