School of Social Development and Public Policy, Beijing Normal University, 19 Xinjie Kouwai Street, Beijing, 100875, China.
Int J Clin Pharm. 2011 Oct;33(5):750-4. doi: 10.1007/s11096-011-9535-9. Epub 2011 Jul 20.
To assess unnecessary use and cost of antibiotics for inpatient care for children under 14 years of age with pneumonia, and to identify the cost distribution in relation to different socio-economic status.
The study was hospital-based and cross-sectional.
Between July 2007 and June 2008, 226 participants were interviewed in two county hospitals and three township health centers in two counties in rural China. The healthcare facilities provided medical and financial records for all study participants. Appropriateness of antibiotic treatment was assessed, in accordance with guidelines, by a paediatrician from a university teaching hospital, who reviewed all medical records. The cost of unnecessary antibiotics was based on the health facilities' price lists.
Unnecessary antibiotic prescriptions occurred in 43% of all patients. The median unnecessary cost of antibiotics was 40 RMB yuan (IQR: 22-100), and this extra cost increased the financial burden for the pneumonia inpatients by 18%. There were no statistically significant differences related to socio-economic categories for unnecessary antibiotics cost (F = 1.43, P = 0.2444).
Unnecessary prescribing of antibiotics use laid an extra burden on children with pneumonia at inpatient care. Implications for policy and practice might be considered regarding incentives, guidelines and training for health care providers.
评估 14 岁以下肺炎住院患儿抗生素的不必要使用和费用，并确定与不同社会经济地位相关的成本分布。
本研究为医院横断面研究。
2007 年 7 月至 2008 年 6 月，在我国农村的两个县的两家县级医院和三家乡镇卫生院对 226 名参与者进行了访谈。医疗保健机构为所有研究参与者提供了医疗和财务记录。由一家大学教学医院的儿科医生按照指南评估抗生素治疗的适当性，他审查了所有的病历。不必要抗生素的费用是根据医疗机构的价格清单计算的。
所有患者中有 43%的患者存在抗生素处方不合理的情况。不必要抗生素的中位数费用为 40 元人民币（IQR：22-100），这额外的费用使肺炎住院患者的经济负担增加了 18%。在不必要抗生素费用方面，社会经济类别之间没有统计学差异（F = 1.43，P = 0.2444）。
抗生素的不合理使用给肺炎住院患儿带来了额外的负担。可能需要考虑针对卫生保健提供者的激励措施、指南和培训。
