Cost analysis of patient management in an out patient department and study of the impact of a cost awareness programme on prescribing practices.

Abstract

A descriptive study conducted in two provincial hospitals situated in the western province of Sri Lanka indicated that the unit cost per patient visit was Rs.27.00.58.6 per cent of this cost was, contributed to by drugs, and 2.9 per cent by investigations and 38.5 per cent by other recurrent expenditure. Among the drugs, over 80 per cent was contributed to by antibiotics. Diseases of the respiratory system was the most common morbidity group contributing to over 45 per cent of OPD attendees and the unit drug costs in this group was Rs.18.44, of which antibiotics contributed to 86.2 per cent. Cost awareness among medical officers was poor. Drug advertisements and detail men were their main source of information on drug costs. An educational intervention based on the findings of the descriptive study and the study conducted among MO ,was developed and implemented in one hospital identified as the study unit. A 20 per cent reduction in the unit cost of drugs per patient was seen following the intervention, mainly in the group, diseases of the respiratory system. This was contributed to by a reduction in the costs related to antibiotic use, specially the use of amoxycilln. The reduction was seen to persist even 4 months after the intervention