Tumwikirize WA., Ogwal-Okeng JW., Mohammed K.,

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Presentation transcript:

Tumwikirize WA., Ogwal-Okeng JW., Mohammed K., ASSESSING THE EFFECTS OF COST SHARING ON AVAILABILITY OF DRUGS AND UTILIZATION OF SERVICES IN PUBLIC HEALTH FACILITIES IN UGANDA Tumwikirize WA., Ogwal-Okeng JW., Mohammed K., Aupont O. INRUD Uganda and Makerere University Project supported as part of the Joint Initiative on Improving Use of Medicine under a grant from RPM Plus

BACKGROUND 1990: introduction of cost sharing policy in public health facilities. Objectives: 1. Encourage patients/caretakers to contribute to health care costs 2. Generate revenue to supplement funding from government. Special considerations for specific categories of people. Policy abolished in March 2001

OBJECTIVES General objective: Specific Objectives: To assess the effect of changes in cost sharing policy on availability of drugs and utilization of services in public hospitals in Uganda. Specific Objectives: Evaluate the effect of the policy changes on outpatient clinic attendance of three pediatric age groups who were differently affected by the policy. To analyze changes in the availability of ED for common illnesses affecting those age groups. To determine the variations in prescription practices for specific pediatric patient populations.

METHODS Longitudinal retrospective research design with stratified study cohorts. Data from pediatric outpatient clinics and stock cards at the hospital pharmacies for a 36-month period. Time series analyses of variations in attendance, drug availability, and prescription characteristics over time

RESULTS Before After

RESULTS (cont.) Before After

Variations in number of drugs per prescription RESULTS (cont.) Variations in number of drugs per prescription

SUMMARY & CONCLUSION Attendance increased with the removal of the cost sharing policy, particularly for the under-fives. Availability of some ED increased with the removal of the policy. Changes in attendance did not affect the availability of the drugs Policy changes did not markedly affect general prescriptions characteristics. Policy implications: After completion of analysis

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