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China should reduce the overuse of intravenous infusion

BMJ 2014; 348 doi: (Published 04 February 2014) Cite this as: BMJ 2014;348:g1262
  1. Sanying Yuan, nurse, Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
  1. ysy404{at}

The Chinese government needs to go further to educate the public and reduce the financial incentives that lead to huge overprescribing of drugs and fluids for intravenous delivery, writes Sanying Yuan

Intravenous infusion of drugs or fluid is normally reserved for patients whose condition cannot be effectively treated by injection or drugs taken orally. Potential overuse of intravenous infusion is a controversial topic in mainland China, in large part because reliable statistics on the consumption are difficult to find. At a 2011 conference to reform the country’s healthcare system, Zhu Zhixin, deputy director of the Chinese National Development and Reform Commission, reported that the country consumed 10.4 billion bottles of infusion fluid in 2009—roughly eight bottles on average for each inhabitant.

Other countries, in contrast, rarely show consumption as high as 2.5 to 3 bottles per person.1 In September 2013, Haiping Deng, spokesman for the Chinese National Health and Family Planning Commission, clarified that the 10.4 billion bottles of infusion fluid mentioned referred to the production, not consumption, of infusion fluid in 2009.2 Despite the difficulties in putting numbers to the problem, both commissions agree that improper use of infusion in Chinese medical institutions needs to be tackled.

According to the Pharmaceutical Industry Association of China, fewer than two bottles of intravenous fluid were consumed per person in 1998, and many factories rushed …

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