Medications prescribing pattern toward insured patients (original) (raw)
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The Shared Experience of Insured and Uninsured Patients: A Comparative Study
Journal of Environmental and Public Health
Background. Despite efforts to ensure equitable quality of care for all patients, a significant gap persists between the quality of care experienced by insured and uninsured patients in Saudi Arabia. This study aims to identify and compare the differences between insured and uninsured patients in terms of their experience of quality of care in a tertiary hospital. Methods. A descriptive cross-sectional study was utilized. Insured and uninsured individuals who had undergone identical medical procedures in early 2021 were identified from a public 500-bed tertiary hospital. About 350 patients participated in this study by completing an online, self-administered questionnaire, adopted by Abuosi and others in 2016, assessing six dimensions of quality of care. Results. Significant differences were reported between the quality of care experienced by insured and uninsured subjects (M = 3.37, SD = 0.525, and M = 3.06, SD = 0.452, respectively, p = 0.001 ). While insured group reported high q...
Insurance coverage among patients admitted in a tertiary care hospital
Panacea Journal of Medical Sciences, 2021
Background: "Health insurance" is an insurance that covers the whole or part of the risk of a person incurring medical expenses, spreading the risk over a large number of persons. Objectives: To find out proportion of insurance coverage among patients admitted in a tertiary care hospital and to assess reasons for non-coverage of insurance. Materials and Methods: Hospital based cross sectional study was conducted among 272 patients admitted in a tertiary care hospital. After taking informed consent, interview of patient was conducted. Data was entered in a predesigned, semi-structured questionnaire. Detailed interview of the patient was conducted regarding coverage of insurance, type of insurance used, reasons for enrolling insurance and reasons for not enrolling insurance. Data was analysed by using EPI INFO statistical software. Results: Insurance coverage was found to be 29%. 44.31% population received information regarding insurance from Friends and relatives. Lack of awareness was the reason reported by 45 % patients for not utilizing insurance. Conclusions: Coverage of insurance was found to be poor. Patients should be made aware regarding various insurance schemes provided by Government for benefit of patients. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Influence of Health Insurance on Rational Use of Drugs
TAF Preventive Medicine Bulletin, 2013
bileşeni ile tanıştı. Kamu çalışanlarına katkı payı içeren bir sağlık güvence paketi sağlandı. Ordu için tüm katkı devlet tarafından ödenmektedir. Sağlık sigortasından önce Nijerya askeri hastanesinde reçeteleme örüntüsü yüksek muayene başına ilaç sayısı, düşük jenerik ilaç kullanımı ve yüksek enjeksiyon kullanımından dolayı akılcı değildi. Bu çalışmanın amacı, Dünya Sağlık Örgütü (DSÖ)'nün kriterlerini kullanarak aynı tesiste sağlık sigprtasının akılcı ilaç kullanımını nasıl etkilediğini incelemektir. YÖNTEM: Ikoyi, Lagos Nijerya'daki Askeri Hastanenin polikliniğinde 2008-2011 arasında kabul edilen hastaların kayıtları üzerinden yürütülen retrospektif kesitsel bir çalışmadır. Veriler tabakalı örnekleme ile rasgele seçilen yıl başına 45 hasta olmak üzere 180 hastanın kayıtlarından toplanmış ve DSÖ'nün istediği reçeteleme indikatörleri hesaplanmıştır. BULGULAR: Toplam 180 hastaların yaşı 1 hafta ile 66 yıl (mean 24,09±17,02) arasındaydı. En fazla hasta büyük gruplar 10 yaş altı (%28,3) ve 30-39 yaş (%27,8) gruplarındaydı. Erkek kadın oranı 1,15'e 1 idi. 180 muayenede 160 hastaya 466 ilaç reçete edilmişti. Muayene başına ilaç sayısı 2,6, jenerik reçeteleme hızı %56,4 ve antibiyotik yazma hızı %35 iken enjeksiyon reçetesi hızı %8,9 idi. Kalitatif çalışmadaki 50 soru formundan 29'u doktorlar 16'sı eczacılar tarafından dolduruldu. Doctorların %82,8'i ve eczacıların %75,0'ı reçete edilmiş ilaçların hasta tarafından ödenme sayısı ile ilgiliydi. Cepten ödeyen hastalar için doktorlar piyasa ismini %44,8 ve jenerik ismi %37,9 önerirken, eczacılar piyasa ismini %81,3 ve jenerik ismi %19,7 önerdiler. Aradaki fark istatistiksel olarak anlamlıydı (p=0.04). SONUÇ: Cepten ödemeden sağlık sigortasına geçişte ödeme şekli değişikliği muayene başına ilaç sayısını azalttı ve jenerik reçetelemeyi arttırdı. Muhtemelen sağlık sigortası altında artmış ödeme gücünden kaynaklanan antibiyotik reçeteleme hızında hafif artış oldu. Nijerya'da sağlık sigortası ajansları paydaşlarını akılcı ilaç kullanımı konusunda aydınlatma ihtiyacı duyarken hükümet sigorta yararlanımlarını optimize ederek kapsanan toplumu genişletmelidir. SUMMARY AIM: In 2005, Nigeria introduced the Formal Sector Social Health Insurance component of National Health Insurance Scheme. This provides public sector workers with a package of health interventions in return for employee and or employers contributions to the scheme. For the military, the entire contribution is paid by the government. Before health insurance was introduced, the prescription pattern at a Nigerian military hospital was reported as irrational with high drugs per encounter, low use of generic prescriptions and high level of injection use. The aim of this study is to evaluate how health insurance affects the rational use of drugs in the same facility using World Health Organisation criteria. METHOD: Retrospective cross-sectional study of case notes of patients seen at the general outpatients clinics of Military Hospital, Ikoyi, Lagos Nigeria between 2008 and 2011. Data collection from 180 case notes sampled through stratified sampling technique to retrieve 45 case notes per year. Materials were collected to calculate prescribing indicators as stipulated by the WHO. RESULTS: From analysis of 180 case notes, patients were aged from 1 week to 66years (mean 24.09±17.02). More patients were below 10years (28.3%) and 30-39 years (27.8%). The overall male to female ratio was 1.15:1. There were 446 drugs prescribed for 160 patients. The average drug encounter rate was 2.6, the generic prescription rate was 56.4%, antibiotic encounter rate was 35.0% while the injection prescription rate was 8.9%. Out of 50 questionnaires in the qualitative study, 29 doctors, 16 pharmacists returned theirs. Doctors (82.8%) and pharmacists (75.0%) were interested in mode of patient payment for prescription medicines. For patients who pay out-ofpocket, while doctors favoured using generic and branded drugs (44.8%), generics (37.9%); pharmacists favoured generic and branded drugs (81.3%) and generics (19.7%) with slight statistical difference (p=0.04) between both professionals. CONCLUSION: The change in payment pattern from out-of-pocket to health insurance has actually reduced average drug prescribed per encounter, increased prescription of generics possibly because hospital reimbursement is at the rate of generics and based on capitation for these group of patients. There was scant moral hazard in the slight increase in antibiotic prescription possibly due to improved affordability under health insurance. Nigerian health insurance agencies need to pursue enlightenment of stake holders on rational drugs use, while government needs to increase the covered population to optimize benefits accruable from health insurance.
Article ID: IJM_12_02_002 of Health Insurance among Insured in a Tertiary Care Hospital
International Journal of Management, 2021
A descriptive study design was carried out to assess the knowledge, awareness, and perception of an insured person about health insurance in a tertiary care hospital. A well-framed structured questionnaire was administered to the opinions of the 384 respondents (insured and uninsured), out of which 92% are insured and only 8% are uninsured. Only a few (12%) of insured do not know how much policy coverage is there for hospital charges and 27% of insured have chosen health insurance policy in order to avail good quality treatment. The result clearly shows that most people are not that aware of the process of initiating cashless hospitalization. Hence the insurance companies, third-party administrators, and the hospital must work in synergy.
Primary Care Physicians' Perceptions of the Effect of Insurance Status on Clinical Decision Making
Annals of Family Medicine, 2006
PURPOSE Americans who do not have health insurance receive fewer health services and have poorer health status than those who have insurance. To better understand this disparity, in this study we characterize primary care physician's perceptions of what effect, if any, patients' insurance status has on their clinical decision making during offi ce visits. METHODS Twenty-fi ve physician members of CAPRICORN, a primary care practice-based research network in metropolitan Washington, DC, completed a brief paper-card survey instrument immediately after each patient encounter during 2 half-day offi ce sessions. Participants saw patients in their usual manner and were given no additional information about their patients or their insurance. RESULTS Eighty-eight percent of participating physicians reported making at least 1 change in clinical management as a result of a patient's insurance status. They reported altering their management during 99 of 409 patient encounters (24.2%). There was a signifi cant difference in the percentage of visits that involved a change in management for privately insured, publicly insured, and uninsured patients (18.7%, 29.5%, and 43.5% respectively, P = .01). Physicians reported discussing insurance issues with patients during 62.6% of visits during which they made a change in management based on insurance status. CONCLUSION Physicians incorporate their patients' insurance status into their clinical decision making and acknowledge they frequently alter their clinical management as a result. Additional research is needed to understand the effect of these changes on patient health and to assist both physicians and patients in enhancing the quality of care delivered within the constraints of the current insurance system.
Medications are the substantial part of health carewith high costeffectiveness that a large share of the household expenditure is allocated to them. In recent years, most developed countries have been faced with increasing Pharmaceutical costs (about 10%-20%). In recent years, Iran's Pharmaceutical costs also have constantly increased. The aim of this study was to evaluate Pharmaceutical coverage, determine Pharmaceutical problems and find ways to overcome the problems. Methods: This study was a comparative-descriptive, review and retrospective study that used library and internet sites as resources. The study has two major phases. In the first phase, we searched primary sources and the internet to find an appropriate model to gather information about Pharmaceutical systems in the selected countries. In the second phase, we collected the information and statistics relating to pharmaceuticuse in outpatients and inpatients from 1994 to 2011 which was formally received from 4 Iranian health insurance organizations.
Profile of Insurance Coverage in a National Inpatient Sample
American Journal of Public Health Research, 2013
To identify the hospitals most strongly impacted by health insurance trends, this study investigated the relationships between hospital characteristics and patterns of insurance coverage in a national inpatient sample. Data from the 2007 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project were used to examine hospital characteristics, aggregated patient characteristics, and payer mix (defined as rates of Medicare, Medicaid, private insurance, and uninsured). Medicare was expected to cover nearly half of all inpatient admissions; however, hospitals showed a wide range of percentages for all payers, and some facilities reported up to 61.5% of visits from uninsured patients. Significant multivariate differences in insurance coverage resulted from bed size, location, region, and patient age, gender, racial, and socioeconomic distributions. Results suggest that reimbursement policy changes may disproportionally impact certain hospitals based on their characteristics and/or patient distribution and may be particularly informative in the current era of potential system-wide reform.
International Journal of Health and Life Sciences, 2021
Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on 341 outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/labo...
Cardiology & Vascular Research, 2018
Aim: This study aims to compare cardiovascular diseases direct costs for patients with and those without medical insurance. Methods: It was a prospective study from Mai 02 to August 31 2016 in the cardiology department of the UH GT. All outpatients aged 15 years and older, who came to visit, accepted to participate in the study and were involved. Direct costs (transport, consultation, labor tests and medicaments) were recorded for each patient at each visit. Data were inserted in a MS Access 2010 database and exported in SPSS 20 for analysis, comparing 2 groups (patients with and without medical insurance). Chi-2 and Fisher tests if applicable were used for statistical tests. Results: All patients seen in the study time (922 patients of whom 62.9% were female and 35.7% between 60-74 years) were included. A proportion of 30.5% had medical insurance (281/922). Patients with diabetes, dyslipidemia and obesity were found among patients with medical insurance with respectively 47.5, 62.4 and 49.2%. Most frequent cardiovascular diseases among patients with medical insurance were high blood pressure without and with complications, acute coronary syndrome with respectively 36.2, 34.7 and 29.2%. Direct costs for patients with medical insurance were 1.06 to 1.77 times higher. Labor tests generated the highest costs. Direct costs for all cardiovascular diseases were higher for patients without medical insurance, up to 4 times for venous thrombo-embolic disease. Total costs were higher for patients with medical insurance.