Objective To investigate the spectrum of diseases and the current situation of antibiotic use in rural hospitals and community health service centers in Chengdu, so as to provide evidence for selecting essential medicines and promoting rational use of antibiotics. Method We selected 7 township/community health institutions, from which we collected inpatient and outpatient information. Information about antibiotic use was also collected, including categories, cost, and dosage. A standard questionnaire was used to investigate physicians’ prescription behavior for principal diseases. Result Urban and rural areas had different spectrums of diseases. The major diseases in urban areas included diabetes mellitus, hypertension, chronic obstructive pulmonary disease, and respiratory tract infection; while those in rural areas were infectious diseases of the respiratory system, digestive system, and urinary system. The physicians’ prescription behavior was mainly based on their personal experience. Antibiotics accounted for 30-50% of the total medicine cost. The top four types of antibiotics with the highest cost were cephalosporins, penicillin, quinolones, and macrolides. Conclusion Based on the different spectrums of diseases, essential drug lists and standard treatment guidelines appropriate for rural health care should be developed to improve the rational use of drugs. Factors such as the average cost of daily dose and the course of treatment should be taken into consideration to reduce the overall cost of medicine. An antimicrobial resistance monitoring system and special training courses on rational use of antibiotics should be utilized in the rural health institutions.
Objective To provide baseline data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development in Chengdu. Methods We selected 7 township/community health institutions and 6 village health posts /street clinics using stratified sampling to take account of the levels of economic development and the distance from the centre of Chengdu We then performed on-site surveys and secondary research. Data were analyzed by using Epidata or Excel. Results The utilization of health institutions was generally good. The number of visits and number of inpatients in medical institutions increased steadily. The utilization rate of hospital beds and doctors’ workload were higher than the national average. The average medical expense per outpatient /inpatient was far lower than the national level. The overall condition of the health institutions that close to the centre of Chengdu was better. Conclusion We should persist in taking advantage of the rural hospitals’ construction to improve village health posts /street clinics and strengthen the national and governmental compensating mechanism for township /community health organizations (village health posts /street clinics), so as to make the basic condition of current township/ community health organizations (village health posts /street clinics) better.
Objective The Chengdu initiative essential medicine policy is part of the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development. We aimed to investigate the current situation of medicine use in rural hospitals and community health service centers, so as to provide evidence for policy-makers to select essential medicines and facilitate rational use of medicines. Method We selected 7 township/community health institutions from which to collect medicine use information, including medicine category, number of medicine categories, cost and consumption. Descriptive analysis and the ABC classification method were applied for statistical analysis. Results The number of medicine categories used in the community health institutions was four times greater than that in the township health institutions. Traditional Chinese medicine preparations accounted for 40% of the total medicine cost. Polypharmacy, overuse of injections, and improper use of antibiotics were major manifestations of the irrational use of medicines. Conclusion The selection and use of essential medicines should be base on high quality evidence as well disease burden, the economic situation and specific demands in different areas. Drug and therapeutics committees should be set up to perform dynamic monitoring, education, evaluation and continual improvement of an essential medicines list.