title: Association between health insurance and antibiotics prescribing in four counties in rural China.
abstract: A cross-sectional study was carried out at county, township and village health care facilities in four counties in rural China in order to describe and compare the effects of health financing systems on antibiotic prescribing in outpatient care. A total of 1232 outpatients at the health care facilities was selected by multi-stage random sampling and were interviewed over 2 weeks. The results showed that health financing systems appeared to influence antibiotic prescribing in outpatient care, both in terms of frequency and of the types prescribed. The insured group had lower prescribing of antibiotics at township and village health care facilities, and for respiratory tract infections, but had higher prescribing of newer antibiotics at county and village health care facilities, for respiratory tract and g-i infections. Because there was a high patient compliance rate (94.3%) in this study the prescribing of antibiotics (supply side behavior) reflected the use of antibiotics (demand side behavior) to a great extent. Thus the results imply that antibiotics prescribing and using might be biased by the patient's health financing systems and antibiotic prescribing was the result of the interaction between physicians and patients.
authors.affiliation: Department of Hospital Management, School of Public Health, Shanghai Medical University, People's Republic of China. jwcao@shmu.edu.cn
authors.forename: H
authors.initials: H
authors.lastname: Dong
authors.forename: L
authors.initials: L
authors.lastname: Bogg
authors.forename: C
authors.initials: C
authors.lastname: Rehnberg
authors.forename: V
authors.initials: V
authors.lastname: Diwan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002681:China; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D010349:Patient Compliance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data*; D012494:Sampling Studies; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents