caa a22 4500 397520220 CHVBK 20180308164630.0 cr unu---uuuuu 161202e199512 xx s 000 0 eng 10.1093/heapol/10.4.423 doi (NATIONALLICENCE)oxford-10.1093/heapol/10.4.423 CHALKER JOHN Save the Children Fund (UK), Hanoi, Vietnam Effect of a drug supply and cost sharing system on prescribing and utilization: a controlled trial from Nepal [Elektronische Daten] [JOHN CHALKER] The effect on prescribing habits of a drug supply and cost sharing system was studied in a hill district in Nepal. In this district the inadequate yearly supply of drugs from the government was supplemented by an extra supply from the project. Drugs were sold at a fixed prescription charge which covered all drugs for one episode of illness. The prescribing pattern in this district was compared to a control district with only the yearly government drug supply and no drug scheme. Drugs prescribed were also compared to theoretical needs based on the recorded diagnoses of the same patients and recommended treatment guidelines. Attendance figures were studied before and after the introduction of the drug scheme in the test district. A 25% sample of prescriptions was taken from all health posts in both districts, over a one year period. This was in total 11 772 prescriptions from 22 health posts. The results show that in the drug scheme district health workers prescribed essential drugs excessively. However, the doses that were prescribed were somewhat better than in the control district. Utilization of health facilities dropped by 18% in the drug scheme district and then increased in the second year. A supply of essential drugs does not necessarily improve the quality of care, or increase attendance levels. The WHO indicators designed to assess the quality of drug use at health facilities can give a misleading picture, as they do not include information on dosages. The effect on quality of care of supply and financing mechanisms needs further study. © Oxford University Press Research reports nationallicence Health Policy and Planning Oxford University Press 10/4(1995-12), 423-430 0268-1080 10:4<423 1995 10 heapol https://doi.org/10.1093/heapol/10.4.423 text/html Onlinezugriff via DOI 1 other jats NATIONALLICENCE 856 40 https://doi.org/10.1093/heapol/10.4.423 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- CHALKER JOHN Save the Children Fund (UK), Hanoi, Vietnam NATIONALLICENCE 773 0- Health Policy and Planning Oxford University Press 10/4(1995-12), 423-430 0268-1080 10:4<423 1995 10 heapol Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford