Background
Methods
Study design
Intervention
Statistical analysis
Results
Rate of PPI prescribing
Rank | 2013 | 2014 | 2015 | 2016 | ||||
---|---|---|---|---|---|---|---|---|
Department | Prescribing rate | Department | Prescribing rate | Department | Prescribing rate | Department | Prescribing rate | |
1 | Hepatobiliary surgery | 80.85 | Intervention | 83.80 | Intervention | 79.68 | Cardiothoracic surgery | 77.44 |
2 | Intervention | 76.94 | Hepatobiliary surgery | 83.68 | Hepatobiliary surgery | 79.33 | Intervention | 76.48 |
3 | Gastroenterology | 75.35 | Gastroenterology | 76.05 | Cardiothoracic surgery | 76.56 | Hepatobiliary surgery | 74.34 |
4 | Cardiovascular medicine | 72.68 | Cardiovascular medicine | 72.14 | Gastroenterology | 70.55 | Gastroenterology | 73.36 |
5 | Hematology | 62.88 | Cardiothoracic surgery | 66.58 | Cardiovascular medicine | 70.34 | Cardiovascular medicine | 69.54 |
6 | Infectious Disease | 60.87 | Urology | 60.37 | Neurosurgery | 66.91 | Neurosurgery | 66.63 |
7 | Oncology | 57.72 | Hematology | 59.99 | Oncology | 60.45 | Rheumatism Immunity | 61.23 |
8 | Urology | 57.41 | Oncology | 59.72 | Hematology | 56.43 | Respiratory | 56.16 |
9 | Gastrointestinal surgery | 56.88 | Gastrointestinal surgery | 58.17 | Respiratory | 55.82 | Hematology | 53.80 |
10 | Cardiothoracic surgery | 56.63 | Respiratory | 52.95 | Urology | 55.72 | Spinal surgery | 52.12 |
Utilization
Expenditure
2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | |
---|---|---|---|---|---|---|---|---|---|---|
Patients (n) | ||||||||||
Outpatients | 608,359 | 675,124 | 732,238 | 818,650 | 987,308 | 1,134,962 | 1,120,506 | 1,241,899 | 1,162,991 | 1,072,400 |
Inpatients | 48,902 | 55,126 | 62,798 | 69,330 | 75,470 | 93,251 | 101,741 | 112,019 | 115,740 | 108,745 |
Total costs of all drugs (million CNY) | ||||||||||
Outpatients | 69.53 | 87.33 | 102.88 | 96.68 | 98.78 | 121.68 | 204.01 | 238.84 | 242.52 | 305.85 |
Inpatients | 124.16 | 146.02 | 173.91 | 226.28 | 271.79 | 390.14 | 476.03 | 458.34 | 617.42 | 610.84 |
PPI cost (million CNY) | ||||||||||
Outpatients | 1.86 | 2.47 | 2.90 | 3.55 | 3.85 | 4.49 | 4.00 | 6.35 | 6.48 | 7.96 |
Inpatients | 3.16 | 3.12 | 4.47 | 6.43 | 6.42 | 12.05 | 16.76 | 20.52 | 25.28 | 21.70 |
PPI cost percentage (%) | ||||||||||
Outpatients | 2.67 | 2.83 | 2.82 | 3.67 | 3.90 | 3.69 | 1.96 | 2.66 | 2.67 | 2.60 |
Inpatients | 2.54 | 2.14 | 2.57 | 2.84 | 2.36 | 3.09 | 3.52 | 4.48 | 4.10 | 3.55 |
Average cost of all drugs (CNY)a | ||||||||||
Outpatients | 114.29 | 129.36 | 140.49 | 118.10 | 100.05 | 107.21 | 182.07 | 192.32 | 208.53 | 285.20 |
Inpatients | 2538.93 | 2648.78 | 2769.31 | 3263.87 | 3601.34 | 4183.81 | 4678.83 | 4091.65 | 5334.54 | 5617.17 |
Average PPI cost (CNY)b | ||||||||||
Outpatients | 102.88 | 119.57 | 122.68 | 128.52 | 109.84 | 109.90 | 104.86 | 145.72 | 140.64 | 151.45 |
Inpatients | 316.22 | 298.09 | 317.05 | 370.12 | 327.36 | 420.84 | 521.14 | 538.48 | 587.03 | 609.37 |
Evaluation of intervention effect
Characteristics | Pre-intervention (n = 300) | Post-intervention (n = 300) |
P
|
---|---|---|---|
Male, n (%) | 182 (60.67) | 166 (55.33) | 0.186 |
Age (yr), mean ± SD | 51.23 ± 13.69 | 49.40 ± 14.99 | 0.118 |
Body mass (kg) | 58.40 ± 9.61 | 56.59 ± 13.99 | 0.065 |
Length of stay (day), Mean ± SD | 10.09 ± 7.17 | 9.91 ± 6.63 | 0.745 |
Prophylactic | 238 (79.33%) | 229 (76.33%) | 0.380 |
Average hospitalization cost (CNY) | 25,166.24 ± 7155.16 | 22,941.26 ± 6939.77 | 0.118 |
Average drug cost (CNY) | 5823.88 ± 1490.91 | 5228.78 ± 1313.89 | 0.037 |
Average PPI cost (CNY) | 657.04 ± 147.05 | 594.02 ± 138.76 | 0.032 |
Pre-intervention n (%) | Post-intervention n (%) |
P
| |
---|---|---|---|
No indication | 171 (57.00) | 122 (40.67) | < 0.001 |
Inappropriate choice of PPI | 21 (7.00) | 1 (0.33) | < 0.001 |
Inappropriate dose | 28 (9.33) | 13 (4.33) | 0.015 |
Inappropriate administration route | 128 (42.67) | 80 (26.67) | < 0.001 |
Inappropriate choice of solvent | 22 (7.33) | 2 (0.67) | < 0.001 |
Inappropriate volume of solvent | 24 (8.00) | 0 (0.00) | < 0.001 |
Unnecessary replacement of drugs | 25 (8.33) | 11 (3.67) | 0.016 |
Inappropriate duration of PPI | 124 (41.33) | 74 (24.67) | < 0.001 |
Appropriate PPI use | 80 (26.67) | 132 (44.00) | < 0.001 |