Effectiveness of the National Health Security Office‘s Policy to Promote Rational Use of Antibiotics by Using Payment for Quality Performance

Abstract

Objective: To study the effect of the policy for promoting rational use of medicines launched by the National Health Security Office (NHSO) by using payment for quality. Method: This study was quantitative research with retrospective data collection from NHSO’s electronic prescriptions database on outpatient services information of 912 hospitals in 12 health regions all over the country. The study compared the use of antibiotics in two target diseases, Acute Gastroenteritis (AGE) and Upper Respiratory Infections (URI) before and after policy implementation i.e., 2012 and 2014. Results: Overall antibiotic use in AGE significantly decreased from 48.57% to 38.56% after policy implementation (p <0.001). Health Service Region 8, Udonthani Province, showed the largest reduction in the rate of antibiotic use from 49.72% to 33.71%. Hospitals under the Ministry of Education had the highest reduction in antibiotic use in this disease, from 47.16% to 24.15%. For URI, the overall antibiotic use decreased significantly from 53.63% to 44.82% during the post intervention period (P <0.001). Health Service Region 8, Udonthani Province, had the biggest reduction in rate of antibiotic use in this disease from 56.16% to 39.14%. Hospitals under the Ministry of Education had the highest reduction in rate of antibiotic use from 58.89% to 47.24%. Conclusion: The NHSO‘s policy for promoting rational use of antibiotics with the mechanism of payment based on the quality of performance reduced the rate of antibiotic use in patients with AGE and URI. It can be used as a tool to raise awareness and stimulate the rational antibiotic use in other diseases.