Zhang, Z, Dawkins, B orcid.org/0000-0002-7038-1975, Hicks, JP orcid.org/0000-0002-0303-6207 et al. (7 more authors) (2018) Cost‐effectiveness analysis of a multi‐dimensional intervention to reduce inappropriate antibiotic prescribing for children with upper respiratory tract infections in China. Tropical Medicine and International Health, 23 (10). pp. 1092-1100. ISSN 1360-2276
Abstract
We developed a multifaceted intervention to reduce antibiotic prescription rate for children with upper respiratory tract infections (URTIs) among primary care doctors in township hospitals in China. The intervention achieved a 29% (95% CI: 16% to 42%) absolute risk reduction in antibiotic prescribing. This study was to assess the cost-effectiveness of our intervention at reducing antibiotic prescribing in rural primary care facilities as measured by the intervention's effect on the APR for childhood URTIs.We took a health-care provider perspective, measuring costs of consultation (time cost of doctor), prescription monitoring process and peer-review meetings (time cost of participants) and medication costs. Costs on provider side were collected through a bespoke questionnaire from all 25 township hospitals in December 2016, while medication costs were collected prospectively in the trial. Incremental cost-effectiveness ratios were calculated by dividing the mean difference in cost of the two trial arms by the mean difference in antibiotic prescribing rate.This showed an incremental cost of $0.03 per percentage point reduction in antibiotic prescribing. In addition to this incremental cost, the cost of implementing the intervention, including training and materials delivered by township hospitals was $390.65 (SD $145.68) per healthcare facility.This study shows that a multifaceted intervention programme, when embedded into routine practice, is very cost-effective at reducing antibiotic prescribing in primary care facilities, and has the potential of scale-up in similar resource limited settings.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Zhang, Z. , Dawkins, B. , Hicks, J. P., Walley, J. D., Hulme, C., Elsey, H., Deng, S. , Lin, M. , Zeng, J. and Wei, X. (2018) Cost‐effectiveness analysis of a multi‐dimensional intervention to reduce inappropriate antibiotic prescribing for children with upper respiratory tract infections in China. Trop Med Int Health, which has been published in final form at https://doi.org/10.1111/tmi.13132. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | cost‐effectiveness; resource limited setting; antimicrobial stewardship; antibiotics prescribing; primary care; rentabilité; établissement à ressources limitées; gestion des antimicrobiens; prescription d'antibiotiques; soins primaires |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Nuffield Centre for International Health and Development (Leeds) |
Funding Information: | Funder Grant number Department for International Development COMDIS-HSD RGNUID 480650 |
Depositing User: | Symplectic Publications |
Date Deposited: | 14 Aug 2018 13:54 |
Last Modified: | 29 Jul 2019 00:44 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/tmi.13132 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:134199 |