Abstract

INFLUENCE OF THIRD PARTY SYSTEM ON RATIONAL DRUG USE IN A TERTIARY HOSPITAL IN BENIN CITY NIGERIA: EXPLORING THE DYNAMICS OF SYSTEMS

Isiboge PD, Ogbonna BO*, Mgbemena BC, Ele GN, Oseji FO, Anetoh MU, Ejie IL, Umeh IB, Nduka IJ, Nwabanne AT, Ofor AC and Onyeyili AN

ABSTRACT

Background: Catastrophic spending is a major limitation of access to quality health care especially in developing countries. Health insurance enables resource pooling and burden sharing serves as a way of eliminating the challenges. Objective: The study assessed the level of rational drug use in National Health Insurance Scheme (NHIS) and non-NHIS facility based on World Health Organization’s (WHO) Standard Drug Use Indicators to generate data for planning and policy. Methods: The study was a cross-sectional survey. Drug utilization in the NHIS and non-NHIS facilities was benchmarked with the WHO Standard Drug Use Indicators. The data was summarized with descriptive statistics. Results: The average number of drugs prescribed per encounter was 3.92 (with range 3.80 – 3.97) for the NHIS clinics and 3.15 (with range 3.05 – 3.30) for the General Practice Clinic (GPC). The average percentage of drugs prescribed from the National essential drugs list was 80.46 (range 40.18 – 92.90) and 90.10 (range of 86.38 – 94.37) for the NHIS and GPC clinics respective. The average percentage of encounter with antibiotics was 12.77 (range 6.48 – 15.44) and 12.86 (range 10.22 – 15.46) for the NHIS and GPC clinics respectively. Conclusion: the third party payment system operational in the NHIS facility negatively influenced drug utilization.

Keywords: healthcare, funding, health insurance, patient care, access to healthcare, Nigeria.