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

Abstract

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. The study assessed the level of rational drug use in National Health Insurance Scheme (NHIS) andnon-NHIS facility based on World Health Organization’s (WHO) Standard Drug Use Indicators to generate data for planning and policy. The study was a cross-sectional survey. Drug utilization in the NHIS and non-NHIS facilities was benchmarked withthe WHO Standard Drug Use Indicators.The data was summarized with descriptive statistics. 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. the third party payment system operational in the NHIS facility negatively influenced drug utilization.