Jung Youn, Cho Hyemin, Ji Eunhee, Park Eun-Ji, Jang Sunmee
Int J Clin Pharmacol Ther. 2018 Apr;56(4):177-183. doi: 10.5414/CP203032.
This study aimed to investigate the factors affecting the geographic differences in antibiotic prescription rates in pediatric upper respiratory tract infections (URI) patients in South Korea.
We performed a nationwide cross-sectional study using 228 administrative districts of Korea, which are the unit of analysis. Prescription rate of antibiotics, the outcome variable, was measured as the proportion of antibiotic prescription days out of total visit days for the treatment of acute URIs using National Health Insurance Service (NHIS) claims data for 2012. Multivariate regression analysis was performed to identify factors affecting geographic variation in antibiotic prescription rates.
The socioeconomic status of the district, as measured by the amount of local property tax payable and the proportion of individuals with higher level of education, were negatively correlated with prescription rate. The degree of competition in the hospital market within a district was positively associated with it. Patients living in areas with better access to family medicine physicians and those living in rural areas were less likely to use antibiotics to treat URIs.
CONCLUSION: Our findings indicate the importance of considering demand factors as well as supply factors when developing intervention strategies for antibiotic overuse. .
本研究旨在调查影响韩国儿科上呼吸道感染（URI）患者抗生素处方率地理差异的因素。
我们以韩国228个行政区为分析单位进行了一项全国性横断面研究。作为结果变量的抗生素处方率，通过使用2012年国民健康保险服务（NHIS）理赔数据，以治疗急性上呼吸道感染的总就诊天数中抗生素处方天数的比例来衡量。进行多变量回归分析以确定影响抗生素处方率地理差异的因素。
以当地应缴纳财产税金额和高学历个体比例衡量的地区社会经济地位与处方率呈负相关。地区内医院市场的竞争程度与之呈正相关。居住在更容易获得家庭医生服务地区的患者以及居住在农村地区的患者使用抗生素治疗上呼吸道感染的可能性较小。
我们的研究结果表明，在制定抗生素过度使用干预策略时，考虑需求因素以及供应因素非常重要。
