Abstract:

Sanming model in healthcare reform has attracted much attention due to its comprehensive and efficient exploration, while its impact on physicians’ prescribing behavior remains unknown. In the present study, we aimed to evaluate the impact of Sanming reform on physicians’ medicine use in county-level public hospitals. We collected outpatient prescriptions in the internal medicine and pediatric departments from nine county public hospitals in Sanming from January 2011 to December 2017. We used six prescribing indicators to analyze physicians’ medicine use. The Mann-Kendall test was used to examine trends in the study outcomes. A total of 1 577 904 outpatient prescriptions were included in this study. The average prescription rate of antibiotics and combined antibiotics were 57.5% and 12.2% in 2011, respectively, which were declined to 28.2% (P = 0.007) and 2.9% (P = 0.003) in 2017, respectively. The average prescription rate of injection was 30.2% in 2011 and declined to 5.3% (P = 0.003) in 2017. As for the subgroup analysis of the internal medicine and pediatric departments, the average prescription rate of antibiotics was 39.3% and 71.4% in 2011, respectively, which was declined to 10.2% (P = 0.003) and 47.3% (P = 0.035) in 2017, respectively. The average prescription rate of combined antibiotics was 15.9% and 9.4% in 2011, respectively, which was declined to 2.9% (P = 0.003) and 2.9% (P = 0.016), respectively. The average prescription rate of injection was 17.8% and 39.6% in 2011, respectively, which was declined to 1.9% (P = 0.003) and 9.0% (P = 0.003), respectively. Our study showed a significant decreasing trend in antibiotic use in county-level public hospitals after the Sanming healthcare reform, indicating that the reform successfully promoted the appropriate use of medicine to some extent.

Key words: Sanming healthcare reform, Medicine use, Prescribing behavior