Doctor's injection prescribing and its correlates in village health clinics across 10 Provinces of Western China

Abstract

BACKGROUND: Unsafe use and overuse of injection play an important role in transmission of very serious blood-borne infections. No studies have been conducted to investigate the levels and determinants of injection utilization in rural Western China. METHODS: A total of 20 125 prescriptions were collected from 680 village clinics across 10 provinces of Western China. A generalized estimating equation logistic regression model was employed to examine the determinants of injection utilization. RESULTS: The proportion of prescriptions with injection was 22.93%. Village doctors who had full-time medical education prescribed less injections than those without full-time education (OR = 0.65; 95% CI: 0.52, 0.80). The injection proportion was higher among children less than 3 years old in comparison with adults aged 18-44 years (OR = 1.72; 95% CI: 1.43, 2.08). The number of drugs in a prescription was also a significant predictor of injection (OR = 1.91; 95% CI: 1.77, 2.06). CONCLUSIONS: Injection prescribing proportion in rural Western China was higher than that in India and lower than that in Cambodia. Injection prescribing was associated with the education of village doctor, patient age and diagnoses of diseases. The findings have important policy implications for recommendations on injection utilization in China.