Wang Xuan, Tang Yuqing, Zhang Xiaopeng, Yin Xi, Du Xin, Zhang Xinping
School of Medicine and Health Management, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, HuBei Province, China.
PLoS One. 2014 Oct 14;9(10):e109594. doi: 10.1371/journal.pone.0109594. eCollection 2014.
Inappropriate use of prescribing pharmaceuticals, particularly injections, not only affects the quality of medical care, but also leads to an increase in medical expenses. Publicly reporting performance data of medical care is becoming a common health policy tool adopted to supervise medical quality. To our knowledge, few studies about public reporting applied to medicine use have been reported. This study intended to introduce public reporting in the field of medicine use, and evaluate the effect of publicly reporting performance data of medicine use on the use of injections.
The research sites were 20 primary healthcare institutions in Q City, Hubei. By matching, the institutions were divided into the intervention group and control group. A quasi-experimental design was applied in this study. In the intervention group, the performance data of medicine use were publicly reported. The injection prescribing rates of the two groups before and after intervention were measured and compared. Difference-in-difference method and logistic regression were employed to estimate the effect of public reporting on injection use.
Public reporting led to a reduction of approximately 4% in the injection prescribing rate four months after intervention (OR = 0.96; 95%CI: 0.94, 0.97). The intervention effect was inconsistent in each month after intervention, and it was most positive in the second month after intervention (OR = 0.90; 95%CI: 0.89, 0.92).
In general, publicly reporting performance data of medicine use may have positive effects on injection use to some extent. Further research is needed to investigate the mechanism by which public reporting influences injection use. Comprehensive measures are also necessary to promote the rational use of injections.
不合理使用药品，尤其是注射剂，不仅会影响医疗质量，还会导致医疗费用增加。公开报告医疗服务绩效数据正成为一种常用的用于监督医疗质量的卫生政策工具。据我们所知，关于公开报告应用于药品使用方面的研究报道较少。本研究旨在引入药品使用领域的公开报告，并评估公开报告药品使用绩效数据对注射剂使用的影响。
研究地点为湖北省Q市的20家基层医疗机构。通过匹配，将这些机构分为干预组和对照组。本研究采用准实验设计。在干预组中，公开报告药品使用绩效数据。测量并比较两组干预前后的注射剂处方率。采用差分法和逻辑回归来估计公开报告对注射剂使用的影响。
干预四个月后，公开报告使注射剂处方率降低了约4%（OR = 0.96；95%CI：0.94，0.97）。干预后各月的干预效果不一致，在干预后第二个月最为明显（OR = 0.90；95%CI：0.89，0.92）。
总体而言，公开报告药品使用绩效数据可能在一定程度上对注射剂使用产生积极影响。需要进一步研究公开报告影响注射剂使用的机制。还需要采取综合措施来促进注射剂的合理使用。
