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THE IRRATIONAL USE OF DRUGS IN RURAL CHINA: EVIDENCES FROM TWO PROVINCES

THE IRRATIONAL USE OF DRUGS IN RURAL CHINA: EVIDENCES FROM TWO PROVINCES. Qiang SUN, Jia YIN, Genyong ZUO, Qingyue MENG Center for Health Management & Policy, Shandong University. Background.

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THE IRRATIONAL USE OF DRUGS IN RURAL CHINA: EVIDENCES FROM TWO PROVINCES

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  1. THE IRRATIONAL USE OF DRUGS IN RURAL CHINA: EVIDENCES FROM TWO PROVINCES Qiang SUN, Jia YIN, Genyong ZUO, Qingyue MENGCenter for Health Management & Policy, Shandong University

  2. Background • Overuse, under use, or misuse of drugs has resulted in wastage of scarce resources, poor quality and unnecessary costs of health care. • The irrational use of drugs in rural China is unclear • Ministry of Health has issued policies and carried out health promotion activities for improving the use of drugs rationally in the hospitals and in the communities.

  3. Study Aims • To evaluate the basic situation of rational use of drugs in rural China by studying the behavior and perception of health care providers and rural residents.

  4. Methods 1 • Design: • A cross-sectional study was designed to evaluate the use of drugs in rural China • Setting: • Shandong and Ningxia provinces in 2008. • In each province, the public hospitals and rural community were the basic study sites

  5. Methods 2 • 3 counties, 9 towns and 54 villages were randomly sampled in each province • Total 13,481 rural residents were investigated in two provinces • 3,000 prescriptions were randomly collected from county hospitals to village clinics in two provinces • 49 health care providers from different levels were interviewed

  6. Results 1 The average No. of drugs and drug cost in Shandong The average No. of drugs and drug cost in Ningxia

  7. Results 2 High Antibiotic use • Accustomed prescription practices of rural health providers and economic incentives from selling drugs are the main reasons resulted in the high antibiotic utilization

  8. Results 3 High Injection Use • Wrong beliefs: The rural patients actively require using the injections as they believe the effect of injections is better than oral drugs. • Economic incentives: The injective drugs usually had higher mark-up

  9. Results 4 • Poor knowledge: over 50% of surveyed populations don’t know consequence of irrational use of antibiotics in both provinces. • Poor adherence: 54.6% and 60% of the rural patients can not comply with medical advice to take drugs in Shandong and Ningxia respectively.

  10. Summary 1 • The irrational use of medicines is very severely in rural China in terms of high antibiotic use and injection use • Economic incentives and lack of continuous training to health care providers are main reasons

  11. Summary 2 • Poor knowledge, wrong beliefs and poor adherence of rural residents on drug use worse the irrational use of medicines

  12. Policy implication and conclusion • Implementing continuous on-the-job trainings on and reforming the incentive mechanism for rural health providers are urgent and essential for improving rational use of drugs in rural China. • Targeted health promotions on rural residents for improving their knowledge and setting up correct beliefs on rational drug use are also important.

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