How cheap is primary health care? Cost per script at the Heidedal Community Health Centre and National District Hospital in Bloemfontein

Abstract

Background: It is essential to manage and budget for primary health care in order to deliver a sustainable, accessible and quality health service to the majority of the population. The aim of the study was to establish the cost per script at the Heidedal Community Health Centre (HCHC) and at the National District Hospital (NDH) in Bloemfontein and to evaluate prescribing patterns, the protocols and use of the Essential Drug List (EDL) and Standard Treatment Guidelines (STGs) and to budget more accurately for medicine. Methods: During a two-month period, every fifth script dispensed at HCHC and NDH was included in the study and analysed until we had included 1 000 scripts from each facility. Results: The mean number of items per script at the CHC was 3.3 and at the DH was 4.1, and the mean cost was R14.66 versus R64.69 respectively. At HCHC, 62 025 prescriptions were dispensed and at NDH 56 312 were dispensed at an estimated total value of R 4.5 million during 2002. Conclusion: Many problem areas and incorrect prescribing patterns were identified and need to be addressed. Although the cost per script at primary care level is not high, the number of patients that need treatment is enormous. Primary health care is actually very expensive and good quality control is necessary.

Prescribing indicators at primary health care centers within the WHO African region: a systematic analysis (1995–2015)

“… Desta et al [ 40 ] 1997 Ethiopia Prospective & Retrospective Prospective 1–2 days Retrospective-1 year n/s Public 18 n/s n.s 2340 15. Dippenar et al [ 41 ] 2006 South Africa Prospective 2 month n/s Public 1 Urban Doctors, nurses 1000 16. Enato et al [ 42 ] 2012 Nigeria Retrospective 6 months n/s Public 1 Rural Doctors, nurses 315 17.…”

“…The overall high levels of antibiotic prescribing may partly be accounted for by the extensively documented high burden of infectious diseases within the African region. For instance, in the studies by Massele et al [ 50 ] in Tanzania, Enato et al [ 41 ] in Nigeria and Bosu and Ofori-Adjei [ 39 ] in Ghana, 58 %, 38.3 % and 22 % of conditions presented at the PHCs, respectively were attributable to infectious diseases (excluding malaria). These high levels of reported infections are likely to contribute to more antibiotic presciption.…”

Is quality control useful? An audit of the saving measures regarding prescriptions at National District Hospital in Bloemfontein

“…In a previous study, the cost of primary health care prescriptions was evaluated and problem areas were identified. 2 In that study, 1 000 prescriptions at both the Heidedal Community Health Centre and the National District Hospital (NDH) in Bloemfontein were evaluated over two-month periods. The average number of items per script was 3.1 and 4.1 respectively, and the average cost per script R11.04 and R64.08 respectively.…”

“…The aim of this study was to evaluate the changes implemented to address the cost of prescribing drugs at NDH, as described in a previous study. 2…”