Limits...
Significant reduction of antibiotic consumption and patients' costs after an action plan in China, 2010-2014.

Bao L, Peng R, Wang Y, Ma R, Ren X, Meng W, Sun F, Fang J, Chen P, Wang Y, Chen Q, Cai J, Jin J, Guo J, Yang S, Mo X, Zhang E, Zhang Y, Lu Z, Chen B, Yue X, Zhu M, Wang Y, Li X, Bian Y, Kong S, Pan W, Ding Q, Cao J, Liu R, Chen N, Huang X, B A, Lyu H - PLoS ONE (2015)

Bottom Line: Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period.Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

ABSTRACT

Introduction: On July 1, 2011, the Chinese government launched a national Action Plan for antibiotic stewardship targeting antibiotic misuse in public hospitals. The aim of this study was to evaluate the impacts of the Action Plan in terms of frequency and intensity of antibiotic utilization and patients costs in public general hospitals.

Methods: Administrative pharmacy data from July 2010 to June 2014 were sampled from 65 public general hospitals and divided into three segments: (1) July 2010 to June 2011 as the preparation period; (2) July 2011 to June 2012 as the intervention period; and (3) July 2012 to June 2014 as the assessment period. The outcome measures included (1) antibiotic prescribing rates; (2) intensity of antibiotic consumption; (3) patients costs; and (4) duration of peri-operative antibiotic treatment in clean surgeries of thyroidectomy, breast, hernia, and orthopedic procedures. Longitudinal and cross-sectional analyses were conducted.

Results: Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period. Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.

Conclusion: The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.

Show MeSH

Related in: MedlinePlus

Changes in patients’ costs.The stack plots represent the average monthly data of costs for inpatients (A) and outpatients (B) during the preparation, intervention, and assessment periods. The costs are summarized as the costs on hospital stay (TO), medication (ME), antibiotics (AN), and very-restricted antibiotics (VR). Cross-sectional analyses were conducted by comparing the average yearly data on patents’ costs on hospital stay, medication, antibiotics, and very-restricted antibiotics (Very-Restricted) for both inpatients (C—F) and outpatients (G—I). P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4359138&req=5

pone.0118868.g002: Changes in patients’ costs.The stack plots represent the average monthly data of costs for inpatients (A) and outpatients (B) during the preparation, intervention, and assessment periods. The costs are summarized as the costs on hospital stay (TO), medication (ME), antibiotics (AN), and very-restricted antibiotics (VR). Cross-sectional analyses were conducted by comparing the average yearly data on patents’ costs on hospital stay, medication, antibiotics, and very-restricted antibiotics (Very-Restricted) for both inpatients (C—F) and outpatients (G—I). P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.

Mentions: The average patients’ costs during the 3 periods are shown in Fig. 2. In the inpatient settings, the total costs on hospital stay remained practically unchanged (slope = -0.71; se = -2.88; p = 0.804) during the intervention period, whereas the average costs on medication showed a significant decrease (level = -41.2; se = 17.7; p < 0.05) at the start of the intervention period (Table 2). The average costs on antibiotics decreased by $6.95 (se = 1.57; p < 0.001) per month during the intervention period for hospitalized patients (Table 2). Similarly, the costs for hospitalized patients on the very-restricted antibiotics showed a significant reduction (slope = -2.08; se = 0.42; p < 0.001) per month during the intervention period (Table 2). Cross-sectional analyses showed significant decreases in the average costs on hospital stay ($1396.2 vs. $1382.2; p = 0.041), medication ($606.7 vs. $541.8; p < 0.001), antibiotics ($203.7 vs. $95.4; a reduction of 53%; p < 0.001), and on the very-restricted antibiotics ($51.3 vs. $6.9; a reduction of 87%; p < 0.001) for hospitalized patients during the assessment period compared with the preparation period (Fig. 2C–2F).


Significant reduction of antibiotic consumption and patients' costs after an action plan in China, 2010-2014.

Bao L, Peng R, Wang Y, Ma R, Ren X, Meng W, Sun F, Fang J, Chen P, Wang Y, Chen Q, Cai J, Jin J, Guo J, Yang S, Mo X, Zhang E, Zhang Y, Lu Z, Chen B, Yue X, Zhu M, Wang Y, Li X, Bian Y, Kong S, Pan W, Ding Q, Cao J, Liu R, Chen N, Huang X, B A, Lyu H - PLoS ONE (2015)

Changes in patients’ costs.The stack plots represent the average monthly data of costs for inpatients (A) and outpatients (B) during the preparation, intervention, and assessment periods. The costs are summarized as the costs on hospital stay (TO), medication (ME), antibiotics (AN), and very-restricted antibiotics (VR). Cross-sectional analyses were conducted by comparing the average yearly data on patents’ costs on hospital stay, medication, antibiotics, and very-restricted antibiotics (Very-Restricted) for both inpatients (C—F) and outpatients (G—I). P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359138&req=5

pone.0118868.g002: Changes in patients’ costs.The stack plots represent the average monthly data of costs for inpatients (A) and outpatients (B) during the preparation, intervention, and assessment periods. The costs are summarized as the costs on hospital stay (TO), medication (ME), antibiotics (AN), and very-restricted antibiotics (VR). Cross-sectional analyses were conducted by comparing the average yearly data on patents’ costs on hospital stay, medication, antibiotics, and very-restricted antibiotics (Very-Restricted) for both inpatients (C—F) and outpatients (G—I). P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.
Mentions: The average patients’ costs during the 3 periods are shown in Fig. 2. In the inpatient settings, the total costs on hospital stay remained practically unchanged (slope = -0.71; se = -2.88; p = 0.804) during the intervention period, whereas the average costs on medication showed a significant decrease (level = -41.2; se = 17.7; p < 0.05) at the start of the intervention period (Table 2). The average costs on antibiotics decreased by $6.95 (se = 1.57; p < 0.001) per month during the intervention period for hospitalized patients (Table 2). Similarly, the costs for hospitalized patients on the very-restricted antibiotics showed a significant reduction (slope = -2.08; se = 0.42; p < 0.001) per month during the intervention period (Table 2). Cross-sectional analyses showed significant decreases in the average costs on hospital stay ($1396.2 vs. $1382.2; p = 0.041), medication ($606.7 vs. $541.8; p < 0.001), antibiotics ($203.7 vs. $95.4; a reduction of 53%; p < 0.001), and on the very-restricted antibiotics ($51.3 vs. $6.9; a reduction of 87%; p < 0.001) for hospitalized patients during the assessment period compared with the preparation period (Fig. 2C–2F).

Bottom Line: Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period.Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

ABSTRACT

Introduction: On July 1, 2011, the Chinese government launched a national Action Plan for antibiotic stewardship targeting antibiotic misuse in public hospitals. The aim of this study was to evaluate the impacts of the Action Plan in terms of frequency and intensity of antibiotic utilization and patients costs in public general hospitals.

Methods: Administrative pharmacy data from July 2010 to June 2014 were sampled from 65 public general hospitals and divided into three segments: (1) July 2010 to June 2011 as the preparation period; (2) July 2011 to June 2012 as the intervention period; and (3) July 2012 to June 2014 as the assessment period. The outcome measures included (1) antibiotic prescribing rates; (2) intensity of antibiotic consumption; (3) patients costs; and (4) duration of peri-operative antibiotic treatment in clean surgeries of thyroidectomy, breast, hernia, and orthopedic procedures. Longitudinal and cross-sectional analyses were conducted.

Results: Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period. Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.

Conclusion: The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.

Show MeSH
Related in: MedlinePlus