Research On The Status Quo And Influencing Factors Of Irrational Use Of Antibacterial Drugs In Rural Medical Institutions

In the process of modern economic development,as an important production factor,human capital is an important driving force for sustainable economic development.Health factors are an important component of human capital,the improvement of health can promote sustained and stable economic growth.For a long time,China's population structure has a relatively high proportion of rural population.Rural human resources,as the main reserve force for national human resources,plays an important role in promoting economic development.The health of the rural population not only has an important impact on economic growth,it is also closely related to the living standards of the rural population.However,the health level of rural population in China is not optimistic.There are still many factors that affect the health status of rural population.Among them,the irrational use of antimicrobials poses a variety of threats to the health of rural population.The irrational use of antimicrobials not only reduces the efficacy,but also causes adverse reactions in humans and exacerbates bacterial resistance.And the excessive use of antibacterial drugs increases medical expenses and causes pollution to the ecological environment.In response to the problem of irrational use of antimicrobials,national department of health has issued a number of drug management policies,adopted management measures,and established a nationwide monitoring network.However,in rural areas,due to the hard implementation of these policies and measures,and the limited means of communication for monitoring,the existing management and monitoring have had little effect on the irrational use of antimicrobials in rural areas.Existing studies have found that the main reason that affects the irrational use of antimicrobials in rural areas is that physicians in medical institutions irrationally prescribe antimicrobials.In order to improve the irrational use of antimicrobials in rural areas,the beginning of finding problems and exploring possible countermeasures is understanding the current status and influencing factors of irrational use of antimicrobials in rural medical institutions.The purpose of this study is to study the current status and influencing factors of irrational use of antibacterial drugs in rural medical institutions.This study used data from 207 township health centers and 139 village clinics in 21 counties in three provinces from July to October 2015.During the data collection process,standardized patient tests were used to obtain the data of irrational use of antibacterial drugs in rural medical institutions,vignette tests were used to obtain a physician's knowledge of the rational use of antibacterial drugs.By statistically analyzing the data,this study compared the results of standardized patient tests and vignette tests to understand the gap between physicians'knowledge and behavior in irrational use of antimicrobial drugs.A Logit model was used to explore relevant factors that influence the physician's behavior and knowledge of the irrational use of antibacterial drugs,to verify the mechanism of the causes of the gap between knowledge and behavior,and to analyze the relevance of physician's behavior and knowledge in the irrational use of antibacterial drugs.The results of the study indicate that the irrational use of antibacterial drugs is widespread in rural medical institutions.The proportion of irrational use of antibacterial drugs in treatment cases was 41%,among these cases that used antibacterial drugs,the proportion of irrational use of broad-spectrum antibacterial drugs was as high as 91%,and the proportion of the use of several antibacterial drugs was 27%.And physicians'knowledge of rational use of antibacterial drugs in rural medical institutions is not high,and there is a gap between physicians' knowledge and behavior in the irrational use of antibacterial drugs,the reasons for the gap can be explained by induced demand.Otherwise,physician's knowledge of the rational use of antibacterial drugs will reduce the use of antibacterial drugs in their actual behavior.Based on the results,this study put forward relevant suggestions for the health management departments and rural medical institutions respectively.For the health management departments,improving doctors' income and adding antibacterial drugs supervisors in rural medical institutions to reduce the knowledge and behavior gaps in the rational use of antibacterial drugs by doctors;and in the rural health system,regularly carry out lectures and training about disease diagnosis and the rational use of antibacterial drugs to raise doctors' knowledge of the rational use of antibacterial drugs.For rural medical institutions,to narrow the gap between the doctors' knowledge and behaviors of rational use of antibacterial drugs through positive/negative incentives;to strengthen the learning of professional knowledge of antimicrobials and the skills training for the rational use of them in rural medical institutions,and regularly carry out knowledge assessment or competition activities to continuously improve the overall knowledge level of physicians by learning and competition.