title: Public reporting as a prescriptions quality improvement measure in primary care settings in China: variations in effects associated with diagnoses.
abstract: The overprovision and irrational use of antibiotics and injections are a major public health concern. Public reporting has been adopted as a strategy to encourage good prescribing practices. This study evaluated the effects of public reporting on antibiotic and injection prescriptions in urban and rural primary care settings in Hubei province, China. A randomized control trial was conducted, with 10 primary care institutions being subject to public reporting and another 10 serving as controls. Prescription indicators were publicly reported monthly over a one-year period. Prescriptions for bronchitis, gastritis and hypertension before and after the intervention were collected. Difference-in-difference tests were performed to estimate the effect size of the intervention on five prescription indicators: percentage of prescriptions containing antibiotics; percentage of prescriptions containing two or more antibiotics; percentage of prescriptions containing injections; percentage of prescriptions containing antibiotic injections; and average prescription cost. Public reporting had varied effects on prescriptions for different diagnoses. It reduced antibiotic prescribing for gastritis. Prescriptions containing injections, especially antibiotic injections, also declined, but only for gastritis. A reduction of prescription costs was noted for bronchitis and gastritis. Public reporting has the potential to encourage good prescribing practices. Its effects vary with different disease conditions.
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R. China.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Tang
authors.affiliation: School of Psychology and Public Health, La Trobe University, Melbourne, Victoria 3086, Australia.
authors.forename: Chaojie
authors.initials: C
authors.lastname: Liu
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R. China.
authors.forename: Xinping
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy*; D002681:China; D003625:Data Collection; D005756:Gastritis / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D057970:Inappropriate Prescribing / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care
chemical_list: D000900:Anti-Bacterial Agents