Lianping Yang|George Liu|Lijun Wang|Xi Yin|Xiaopeng Zhang
Public reporting improves antibiotic prescribing for upper respiratory tract infections in primary care: a matched-pair cluster-randomized trial in China
Huazhong University of Science and Technology|La Trobe University|Huazhong University of Science and Technology|Huazhong University of Science and Technology|Huazhong University of Science and Technology
inappropriate use overuse antibiotics serious concern treatment upper respiratory tract infections urtis especially developing countries recent decades information disclosure public reporting pr become instrument encouraging good practice healthcare study evaluated impact pr antibiotic prescribing urtis sample primary care institutions chinaa matchedpair clusterrandomized trial undertaken qj city 20 primary care institutions participating trial participating institutions matched pairs randomly assigned control intervention group prescription statistics disclosed patients health authorities health workers monthly within intervention group starting october 2013 outpatient prescriptions urtis collected groups 1st march 31st may 2013 intervention 1st march 31st may 2014 total 34815 urti prescriptions included differenceindifference analysis using multivariate linear logistic regression models controlling patient attributes well institutional characteristicsoverall 90 urti prescriptions required antibiotics 21 required combined use antibiotics 77 urti prescriptions required intravenous iv injection infusion drugs pr resulted 9 percentage point 95 ci 17 1 reduction use oral antibiotics adjusted rr 39 p 0027 use injectable antibiotics remained unchanged pr led 7 percentage point reduction 95 ci 14 0 adjusted rr 36 combined use antibiotics p 0049 largely driven significant reduction male patients 75 95 ci 14 1 p 003 intervention little impact use iv injections infusions total prescription expenditurethe results suggest pr could improve prescribing practices terms reducing oral antibiotics combined use antibiotics however impacts limited suggest pr would probably enhanced provider payment reform management training providers health education patients