Taipei Medical University, Taiwan
Usman Iqbal is currently a Health Informatics Researcher and project manager of several national and international Health IT projects at Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University. He has been an author of many scientific articles and he has also participated at many national and international medical conferences. He has been awarded with the ISA-TMU scholarship for two years Master’s program in 2010 and also in 2012 for three years Doctoral program in Health Informatics. His areas of focus are on Observational Health Data and Informatics, Hospital Information System (HIS) for patient safety, and Electronic Medical Records and Telemedicine & Mobile Health at resource poor settings.
Irrational and imprudent antibiotics prescribing for acute bronchitis is a greater concern in globally. We got interested to see the whether the policy implication for antibiotics prescription on Taiwanese physicians would influence in following years or not. We analyzed the antibiotics prescribing trends for acute bronchitis by using 1 million population cohort data from Taiwan’s Bureau National Health Insurance Database of 1998-2011 years. We selected all subjects who visited with acute bronchitis and presence of antibiotics prescription for 18-44 and 45-64 age and sex groups. The patients who were admitted to the hospital or visits associated with chronic pulmonary disease, immunodeficiency, cancer, or concomitant infectious diagnoses were excluded from the study. We found a total of 257446 visits for acute bronchitis who met our study inclusion criteria. We take into account the specialty or settings such as medical center, area hospital, local hospital and non-evaluation hospitals as well as the region of the hospitals Taipei, Northern, Central, Southern, Pingtung and Eastern to mimic the bias. We observed that the overall antibiotic prescription rate was 33.0%. However, the actual antibiotic prescription rate was observed 57.0% for years 1998 to 2001. From 2002 the results showed that there was a significant reduction in the antibiotic prescription to 28.2%. Our results provided evidence that the new laws and regulations introduced for reimbursement purposes by BNHI Taiwan in 2001 related to upper respiratory tract infections, discouraged physicians from prescribing antibiotics if it is not proven by a bacterial infection through blood examination. The behavioral change was observed up to 20% patients with proven bacterial infection.
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