Cost-analysis of antibiotic prescription for upper respiratory infections (URIs) and acute diarrhea (AD) from hospital perspective: A cross sectional study in Noenmaprang district hospital

Abstract

© Faculty of Pharmacy, Mahidol University (Thailand) 2018. Ministry of Public Health, Thailand, implemented key performance indicators (KPIs) for rational drug use (RDU) since 2016. The target was limitation of antibiotic prescription for less than 20% among upper respiratory infections (URIs) and acute diarrhea (AD) patients. This cross sectional descriptive study aimed to define the direct cost of antibiotics from a hospital perspective. URI and AD cases, during February to April 2017, were selected by the designated ICD-10 codes. We separated patients into 3 main groups; rational, irrational, and controversial group. In terms of controversial and irrational indications of antibiotic prescription, we investigated 203 and 962 URI visits and 62 and 247 AD visits, respectively. All cost data were presented in Thai baht where 1.00 US dollar = 33.2 baht in 2017. The total cost of antibiotics was 13,621 baht for URI and 1,648 baht for AD. We found 21 AD visits in irrational group that had risk factors and potential to characterize as rational use. This consumed 616 baht, therefore it was 1,032 baht of antibiotics cost for AD visits. The overall cost of OPD service charge and antibiotic cost for URI and AD were 54,216 and 23,775 baht, respectively. The most common prescribed antibiotic was amoxicillin. The result failed the target KPIs. This value revealed to hospital administrator in implementing a much greater use of evidence-based diagnostic and treatment guidelines by health professionals.