Learning from claim data

General practitioners (GPs) often prescribe antibiotics indiscriminately for respiratory and urinary tract infections. We want to encourage them to use antibiotics more cautiously. To do this we are using the claim data from the three biggest health insurances (3.8 million insureds, or 40% of the Swiss population) to produce an ongoing evaluation of GPs’ prescribing habits. We provide nearly 2,500 GPs with regular feedback on this as well as with information on the development of resistance in their catchment area. We also provide them with guidelines for treating respiratory and urinary tract infections. We then use the data from the health insurances to analyse the impact of this intervention. All the data are anonymous; we do not know the names of any of the doctors or patients.

Targeted measures, known as stewardship programmes, have been implemented successfully in many countries to improve the way antibiotics are used. There is little experience of this in Switzerland, however.

Our goal is to develop an effective intervention programme that will encourage general practitioners to use antibiotics more specifically when treating respiratory and urinary tract infections.

If our approach proves useful, it will be relatively easy to extend it to all GPs in Switzerland. We will also be linking the prescribing data that have been collected with the data in the national antibiotic resistance database (ANRESIS). This will make it possible to generate a predictive model for the development of resistance in urinary tract infections in primary care.

Routine antibiotic prescription and resistance monitoring in primary care physicians: A nationwide pragmatic randomized controlled trial