Exploring the Impact of the Rational Antibiotic Use System on Hospital Performance: The Direct Effect and the Spillover Effect

Abstract

Irrational antibiotic usage not only causes an increase in antibiotic-borne diseases, but also inflicts pain on patients, as a result of inappropriate treatment. In order to resolve the hazards caused by irrational antibiotic usage, a kind of e-health service, the Rational Antibiotic Use System (RAUS), has been incorporated into the hospital information system. The RAUS provides doctors and patients with the functions of antibiotic usage monitoring, antibiotic information consultation and antibiotic prescription support. Though existing literature has already proved the usefulness of the RAUS on monitoring doctors’ behavior, the effects on hospital performance from an organizational perspective has rarely been measured by empirical data. Therefore, our study has explored the effects of the RAUS on the performance of a large Chinese hospital, which has implemented the RAUS since March 2014. Through empirical research, we quantified the effects of the implementation of the RAUS on a hospital’s performance from both the direct effects on the “drug income” and the spillover effect on the “treatment income”. The results indicate a significant positive spillover effect on the treatment incomes of a hospital in its inpatient activities (seen as significant in the long term) and in its outpatient activities (seen as significant in both the short and long terms). In addition, this research provides certain theoretical and practical implications for the dilemma of e-health services application in irrational antibiotic usage.

Phenotypic Detection of Methicillin and Inducible Clindamycin Resistant Staphylococcus Aureus: An Effort to Combat Antimicrobial Resistance and Improve Patient Safety in Gombe, Nigeria

“…These disparities are mainly due to variation in site and time of the studies while few are due to differences in the detection method. Most of the studies used phenotypic detection methods and also emphasized the need for routine reporting of these common MDROs to guide in rational use of antimicrobials and for good antimicrobial stewardship that will ensure patient safety (18,19). Association of both MRSA and inducible clindamycin resistance with individual resistance to erythromycin and clindamycin as observed in this study is similarly reported by several other studies in Nigeria and other countries (5, 9-11, 17, 20).…”

Community Health Nurses’ Perspective on the Introduced Rational Drug Use Policy in Primary Care Settings in Thailand: A Descriptive Qualitative Study

“…The criterion for starred SDHs standard is an effective strategy for the development of primary care prescribing in the community [ 25 ]. In addition, evidence shows that implementing the RDU campaign could effectively improve rational antibiotic prescribing in primary care and hospital in both short- and long-term maintenance [ 26 , 27 ], whereas the reward plays a motivational role to support and urge workers to produce a good performance and high-quality work [ 28 , 29 ].…”