Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study
Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short sup...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Complementary Medicine and Therapies |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12906-020-03141-w |
| _version_ | 1818554843849031680 |
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| author | Shan Wang Lihua Liu Jianchao Liu Likun Miao Qian Zhuang Ning Guo Jing Zhao Quanzheng Li Guoquan Ren |
| author_facet | Shan Wang Lihua Liu Jianchao Liu Likun Miao Qian Zhuang Ning Guo Jing Zhao Quanzheng Li Guoquan Ren |
| author_sort | Shan Wang |
| collection | DOAJ |
| description | Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced. |
| first_indexed | 2024-12-12T09:45:24Z |
| format | Article |
| id | doaj.art-e7d713d616614c10a89f1cb316df0781 |
| institution | Directory Open Access Journal |
| issn | 2662-7671 |
| language | English |
| last_indexed | 2024-12-12T09:45:24Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Complementary Medicine and Therapies |
| spelling | doaj.art-e7d713d616614c10a89f1cb316df07812022-12-22T00:28:25ZengBMCBMC Complementary Medicine and Therapies2662-76712020-11-0120111010.1186/s12906-020-03141-wCharacteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional studyShan Wang0Lihua Liu1Jianchao Liu2Likun Miao3Qian Zhuang4Ning Guo5Jing Zhao6Quanzheng Li7Guoquan Ren8Chinese People’s Liberation Army General HospitalChinese People’s Liberation Army General HospitalChinese People’s Liberation Army General HospitalChinese People’s Liberation Army General HospitalChinese People’s Liberation Army General HospitalMassachusetts General Hospital, Center for Advanced Medical Computing and AnalysisChinese People’s Liberation Army General HospitalChina National Engineering Laboratory of Application Technology in Medical Big DataChinese People’s Liberation Army General HospitalAbstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.http://link.springer.com/article/10.1186/s12906-020-03141-wUpper respiratory tract infectionsPrescriptionCostPediatricOutpatientChina |
| spellingShingle | Shan Wang Lihua Liu Jianchao Liu Likun Miao Qian Zhuang Ning Guo Jing Zhao Quanzheng Li Guoquan Ren Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study BMC Complementary Medicine and Therapies Upper respiratory tract infections Prescription Cost Pediatric Outpatient China |
| title | Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study |
| title_full | Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study |
| title_fullStr | Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study |
| title_full_unstemmed | Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study |
| title_short | Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study |
| title_sort | characteristics of prescriptions and costs for acute upper respiratory tract infections in chinese outpatient pediatric patients a nationwide cross sectional study |
| topic | Upper respiratory tract infections Prescription Cost Pediatric Outpatient China |
| url | http://link.springer.com/article/10.1186/s12906-020-03141-w |
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