Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric
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(2020) 20:346
RESEARCH ARTICLE
BMC Complementary Medicine and Therapies
Open Access
Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study Shan Wang1,2,3†, Lihua Liu1,2†, Jianchao Liu1,2, Likun Miao1,2, Qian Zhuang1,2, Ning Guo4, Jing Zhao1, Quanzheng Li2,4,5† and Guoquan Ren1,2*†
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. (Continued on next page)
* Correspondence: [email protected] † Shan Wang and Lihua Liu contributed equally to this work. † Guoquan Ren and Quanzheng Li are joint senior authors. 1 Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Haidian, Beijing 100853, China 2 China National Engineering Laboratory of Application Technology in Medical Big Data, 28 Fuxing Road, Haidian, Beijing 100853, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as l
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