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The problem
Intervention: Financial incentive policy enabling healthcare facilities to claim ¥800 (approximately $5.7) per case where a rationale for not prescribing antibiotics is offered to children aged <3 years with acute upper respiratory tract infections or gastroenteritis
Who it was tested with: 165,113 children born between April 2017 and March 2019 in Japan; comparison between those exposed to the policy and unexposed controls.
Children or communities are compared with a group that did not receive the intervention, or followed over years. This is the design that best separates what the intervention did from everything else that changed.
"We conducted a quasi-experimental study using a staggered difference-in-differences design with propensity score matching. Data from 165 113 children born between April 2017 and March 2019 were extracted from 2 nationwide administrative databases." This design allows comparison of antibiotic prescriptions before and after policy introduction across matched groups over an extended follow-up period.
Study conducted in Japan's healthcare system; generalizability to other healthcare contexts uncertain. The dose-response relationship leveling off after 5 incentives suggests diminishing returns. Long-term sustainability of provider behavior change not addressed beyond the 4-year study period.
Across countries and designs
1 study · 1 country
