Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016
Background: Overuse of antibiotics may not only increase the burden of antimicrobial resistance, but also accelerate the growth of healthcare expenditures. China has issued a series of policies to improve antibiotic use and reduce the cost of medicine in healthcare institutions. This study aimed to...
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doaj-dc82218ccd2145e68e783a20726a90b62020-11-25T01:06:02ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122018-12-01910.3389/fphar.2018.01396415234Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016Jia Yin0Jia Yin1Caixia Wu2Xiaolin Wei3Qiang Sun4Qiang Sun5School of Health Care Management, Shandong University, Jinan, ChinaNHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, ChinaDepartment of Pharmacy, Shandong Medical College, Linyi, ChinaDalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaSchool of Health Care Management, Shandong University, Jinan, ChinaNHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, ChinaBackground: Overuse of antibiotics may not only increase the burden of antimicrobial resistance, but also accelerate the growth of healthcare expenditures. China has issued a series of policies to improve antibiotic use and reduce the cost of medicine in healthcare institutions. This study aimed to evaluate the trends of antibiotic expenditure in public healthcare institutions in Shandong from 2012 to 2016 and to assess antibiotic expenditure by drug class and the level of healthcare institutions.Methods: We collected data from the centralized bidding procurement (CBP) system in Shandong province between 2012 and 2016. Governmental health facilities including secondary and tertiary hospitals, and urban and rural primary healthcare centers (PHCs) procured antibiotics via this system. Antibiotics were classified according to the Anatomical Therapeutic Chemical (ATC) classification system. Antibiotic expenditure was assessed using total annual expenditure (US dollars) and expenditure per person per year (US dollars).Results: The overall antibiotic expenditure was $717 million in 2016, a 56% increase compared to 2012. Parenteral antibiotics accounted for 84% of the total antibiotic expenditure in 2016. Most of the antibiotics were procured by secondary and tertiary hospitals (33 and 44%, respectively). The expenditures continuously increased in secondary hospitals, tertiary hospitals, and urban PHCs from 2012 to 2016, while antibiotic procurement decreased in urban PHCs since 2015. The third-generation cephalosporins (J01DD) were among the top five ATC classes of antibiotics in all healthcare institutions. Fluoroquinolones (J01MA) were commonly procured by tertiary hospitals, rural and urban PHCs. The expenditure on carbapenems (J01DH) raised sharply in tertiary hospitals.Conclusions: The overall antibiotic expenditure kept increasing in the public healthcare institutions in Shandong. The trends of increasing expenditure began to decline in 2016, which may be associated with antibiotic stewardship initiatives. The expenditure for expensive and critical important classes of antibiotics increased, therefore it is of importance to develop policies on improving the rational use of antibiotics.https://www.frontiersin.org/article/10.3389/fphar.2018.01396/fullantibioticsexpenditurepublic healthcare institutionsstewardshipzero mark-upChina |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jia Yin Jia Yin Caixia Wu Xiaolin Wei Qiang Sun Qiang Sun |
spellingShingle |
Jia Yin Jia Yin Caixia Wu Xiaolin Wei Qiang Sun Qiang Sun Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016 Frontiers in Pharmacology antibiotics expenditure public healthcare institutions stewardship zero mark-up China |
author_facet |
Jia Yin Jia Yin Caixia Wu Xiaolin Wei Qiang Sun Qiang Sun |
author_sort |
Jia Yin |
title |
Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016 |
title_short |
Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016 |
title_full |
Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016 |
title_fullStr |
Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016 |
title_full_unstemmed |
Antibiotic Expenditure by Public Healthcare Institutions in Shandong Province in China, 2012–2016 |
title_sort |
antibiotic expenditure by public healthcare institutions in shandong province in china, 2012–2016 |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pharmacology |
issn |
1663-9812 |
publishDate |
2018-12-01 |
description |
Background: Overuse of antibiotics may not only increase the burden of antimicrobial resistance, but also accelerate the growth of healthcare expenditures. China has issued a series of policies to improve antibiotic use and reduce the cost of medicine in healthcare institutions. This study aimed to evaluate the trends of antibiotic expenditure in public healthcare institutions in Shandong from 2012 to 2016 and to assess antibiotic expenditure by drug class and the level of healthcare institutions.Methods: We collected data from the centralized bidding procurement (CBP) system in Shandong province between 2012 and 2016. Governmental health facilities including secondary and tertiary hospitals, and urban and rural primary healthcare centers (PHCs) procured antibiotics via this system. Antibiotics were classified according to the Anatomical Therapeutic Chemical (ATC) classification system. Antibiotic expenditure was assessed using total annual expenditure (US dollars) and expenditure per person per year (US dollars).Results: The overall antibiotic expenditure was $717 million in 2016, a 56% increase compared to 2012. Parenteral antibiotics accounted for 84% of the total antibiotic expenditure in 2016. Most of the antibiotics were procured by secondary and tertiary hospitals (33 and 44%, respectively). The expenditures continuously increased in secondary hospitals, tertiary hospitals, and urban PHCs from 2012 to 2016, while antibiotic procurement decreased in urban PHCs since 2015. The third-generation cephalosporins (J01DD) were among the top five ATC classes of antibiotics in all healthcare institutions. Fluoroquinolones (J01MA) were commonly procured by tertiary hospitals, rural and urban PHCs. The expenditure on carbapenems (J01DH) raised sharply in tertiary hospitals.Conclusions: The overall antibiotic expenditure kept increasing in the public healthcare institutions in Shandong. The trends of increasing expenditure began to decline in 2016, which may be associated with antibiotic stewardship initiatives. The expenditure for expensive and critical important classes of antibiotics increased, therefore it is of importance to develop policies on improving the rational use of antibiotics. |
topic |
antibiotics expenditure public healthcare institutions stewardship zero mark-up China |
url |
https://www.frontiersin.org/article/10.3389/fphar.2018.01396/full |
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