Co-payment Effect on Drug Rational Use and Cost Coverage at Governmental Primary Health Care in Gaza Governorates
Date
2009-02-25
Authors
Khalid M. Abu Saman
خالد محمد محمود ابو سمعان
Journal Title
Journal ISSN
Volume Title
Publisher
Al-Quds University
Abstract
Drug expenditure represents large amount of health care spending in most countries. Large
spending on drugs causes loss of resources which could be deployed to other health care
services. Also, the irrational use of drugs can lead to wasting of resources and health
hazards as well. This study aimed to study the effect of co-payment on patients' drugs
utilization, and also to study drugs cost coverage at the governmental PHC sector in Gaza
Strip.
The researcher used a descriptive, analytical, cross sectional design. A retrospective
multistage sample of 1620 prescriptions was taken from randomly selected 15 PHC clinics
from the different geographical areas and the different PHC levels. 108 prescriptions from
each selected clinic were taken. Additionally, the researcher reviewed the pharmacy
registry at the targeted clinics to ascertain drug cost coverage and drugs availability.
The study showed that, there are drugs exploitation particularly for the exempted patients,
where the average number of drugs prescribed per prescription was 2.9 (4.5 for exempted,
2.2 for under 3 years and 2 for over 3 year); the average percent of prescriptions including
antibiotics per clinic was 64% (79.1% for exempted, 66.3% for under 3 years and 47% for
over 3 years). The availability of key drugs was 82.8%. The percent of attendants treated
with drugs is 75.4% (88.2% for under 3 year, and 70% for over 3 year visitors). The
average drug cost covered by drug co-payment was 84%, more in rural areas than urban
ones and the average prescription cost per clinic was 4.9 NIS (1.4US$) more in urban than
rural areas.
The study concluded that the introduction or increasing co-payment will decrease the
quantity of the consumed drugs; helping in drug rational use. The study recommends
reviewing the current exemption and co-payment system. Additionally, interventions to
increase patient and physician knowledge about economical and healthy adverse effect for
irrational drug use are needed