Interventions for prudent antibiotic use in primary healthcare: an econometric analysis

BMC Health Services Research

Christina Åhrén¹  Gunnar Jacobsson²  Peter Ulleryd³  Fredrik Carlsson⁴  Elina Lampi⁴  Pär-Daniel Sundvall⁵  Marcela Jaime Torres⁶ 

[1] Center for Antibiotic Resistance Research (CARe), University of Gothenburg, Guldhedsgatan 10, 405 30, Gothenburg, SE, Sweden;Swedish Strategic Program against Antimicrobial Resistance (Strama), Region Västra Götaland, Bergslagsgatan 2, SE-411 04, Gothenburg, Sweden;Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 9 A-B, SE-413 90, Gothenburg, Sweden;Center for Antibiotic Resistance Research (CARe), University of Gothenburg, Guldhedsgatan 10, 405 30, Gothenburg, SE, Sweden;Swedish Strategic Program against Antimicrobial Resistance (Strama), Region Västra Götaland, Bergslagsgatan 2, SE-411 04, Gothenburg, Sweden;Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 9 A-B, SE-413 90, Gothenburg, Sweden;Department of Infectious Diseases, Skaraborg Hospital, Lövängsvägen, SE-541 42, Skövde, Sweden;Department of Communicable Disease Control and Prevention, Region Västra Götaland, Kaserntorget 11B, SE-411 18, Gothenburg, Sweden;Swedish Strategic Program against Antimicrobial Resistance (Strama), Region Västra Götaland, Bergslagsgatan 2, SE-411 04, Gothenburg, Sweden;Department of Economics, University of Gothenburg, Vasagatan 1, SE-411 24, Gothenburg, Sweden;Center for Antibiotic Resistance Research (CARe), University of Gothenburg, Guldhedsgatan 10, 405 30, Gothenburg, SE, Sweden;Region Västra Götaland, Research and Development Primary Health Care, Research and Development Centre Södra Älvsborg, Sven Eriksonsplatsen 4, SE-503 38, Borås, Sweden;Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 454, SE-405 30, Gothenburg, Sweden;School of Management and Business, Research Nucleus on Environmental and Natural Resource Economics (NENRE), Universidad de Concepción, Victoria 471, Barrio Universitario, Concepción, Chile;

关键词: Health services research;    Primary healthcare;    Quality improvement;    Antibiotics;    Intervention;    Self-evaluation;   

DOI  :  10.1186/s12913-020-05732-2

来源: Springer

【 摘 要 】

BackgroundRational antibiotic prescribing is crucial to combat antibiotic resistance. Optimal strategies to improve antibiotic use are not known. Strama, the Swedish strategic program against antibiotic resistance, has been successful in reducing antibiotic prescription rates. This study investigates whether two specific interventions directed toward healthcare centers, an informational visit and a self-evaluation meeting, played a role in observed reduction in rates of antibiotic prescriptions in primary healthcare.MethodsThe study was a retrospective, observational, empirical analysis exploiting the variation in the timing of the interventions and considering past prescriptions through use of estimations from dynamic panel data models. Primary healthcare data from 2011 to 2014 were examined. Data were from public and private primary healthcare centers in western Sweden. The key variables were prescription of antibiotics and indicator variables for the two interventions.ResultsThe first intervention, an educational information intervention, decreased the number of prescriptions among public healthcare centers, but this effect was only temporary. We found no proof that the second intervention, a self-evaluation meeting at the healthcare center, had an impact on the reduction of prescriptions.ConclusionsSingle educational interventions aimed at influencing rates of antibiotic prescriptions have limited impact. A multifaceted approach is needed in efforts to reduce the use of antibiotics in primary health care.

【 授权许可】

CC BY