Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Drug Prescription Patterns and Utilization after Family Physician Program Implementation in Rural Health Centers of Isfahan District, Iran

Document Type : Original Article (s)

Authors
Reza Khadivi 1
Amin Yarahmadi 2
Rezvan Eslamieh 3
Mahbubeh Khosravinejad 4
1 Associate Professor, Health Social Determinants Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 Pharmacist, Drug Affair, Isfahan District Health Center NO.2, Isfahan University of Medical Sciences, Isfahan, Iran
4 Drug Affair, Isfahan District Health Center NO.1, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Health sector reform as "Family Physician" (FP) program has been introduced in 2004 in rural and lower than 20 thousands population cities of Iran. This study aimed to reveal the utilization rate of general practice visit and prescription pattern in the rural health centers before and after the Family Physician program in rural health centers of Isfahan district.Methods: We retrospectively assessed the number of prescriptions per year and in other mean, the average medical contacts per person, before and after implementation of Family Physician program in 2004 and 2011 in a cross-sectional study during the year 2012. In addition, we assembled the mean number of drugs per prescription and drug costs. Data were collected in 17 rural health centers of Isfahan district in the central of Iran.Findings: The prescription numbers in 2011 was 3.58 times more than such practiced in 2004. The prescriptions per capita were 0.145 and 0.64 in 2004 and 2011, respectively. The more prescriptions had done in spring and winter in both years. The mean number of drugs prescribed per encounter decreased from 4.27 ± 0.69 in 2004 to 4.11±0.56 in 2011. The per capita drug costs increased 4.87 times in 2011 in comparison with 2004.Conclusion: Following Family Physician program implementation, the prescriptions per capita were increased. In otherwise, the access to general physician (equity) improved. In addition, the mean number of drugs prescribed per encounter decreased. Thus, following Family Physician program, technical efficiency has been developed.
Keywords
Medicine
Equity
Efficiency
Developing Country
Iran
  1. Yang H, Dib HH, Zhu M, Qi G, Zhang X. Prices, availability and affordability of essential medicines in rural areas of Hubei Province, China. Health Policy Plan 2010; 25(3): 219-29.
  2. Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet 2009; 373(9659): 240-9.
  3. Roberts MJ, Hsiao W, Berman P, Reich MR. Getting Health Reform Right: A Guide to Improving Performance and Equity. Oxford, UK: Oxford University Press; 2004.
  4. Christensen DB, Bush PJ. Drug prescribing: patterns, problems and proposals. Soc Sci Med A 1981; 15(3 Pt 2): 343-55.
  5. Cheraghali AM, Nikfar S, Behmanesh Y, Rahimi V, Habibipour F, Tirdad R, et al. Evaluation of availability, accessibility and prescribing pattern of medicines in the Islamic Republic of Iran. East Mediterr Health J 2004; 10(3): 406-15.
  6. Gressani D, Larbi H, Fetini H. Islamic Republic of Iran Health Sector Review: Volume II: Background Sections. Washington, DC: The World Bank Group; 2008.
  7. Regional Initiative of Health Sector Reform for Latin America and the Caribbean. Methodology for Monitoring and Evaluation of Health Sector Reform in Latin America and the Caribbean. Washington, DC: Regional Initiative of Health Sector Reform for Latin America and the Caribbean; 1998.
  8. Kang HY, Park CY, Joong Kim HJ. Public attitude and knowledge on a new health policy for pharmaceutical care in Korea. Health Policy 2002; 62(2): 195-209.
  9. Hadsall RS, Freeman RA, Norwood GJ. Factors related to the prescribing of selected psychotropic drugs by primary care physicians. Soc Sci Med 1982; 16(20): 1747-56.
  10. Naghavi M, Jamshidi HR. Utilization of Healthcare Services in Iran in Year 2002. Tehran, Iran: Tandis Publication; 2005.
  11. Koppel A, Meiesaar K, Valtonen H, Metsa A, Lember M. Evaluation of primary health care reform in Estonia. Soc Sci Med 2003; 56(12): 2461-6.
  12. Moghadamnia AA, Mirbolooki MR, Aghili MB. General practitioner prescribing patterns in Babol city, Islamic Republic of Iran. East Mediterr Health J 2002; 8(4-5): 550-5.
  13. Cheraghali AM, Idries AM. Availability, affordability, and prescribing pattern of medicines in Sudan. Pharm World Sci 2009; 31(2): 209-15.
  14. Kim HJ, Chung W, Lee SG. Lessons from Korea's pharmaceutical policy reform: the separation of medical institutions and pharmacies for outpatient care. Health Policy 2004; 68(3): 267-75.
Journal of Isfahan Medical School
Volume 31, Issue 271 - Serial Number 271
November and December 2014
Pages 2403-2411

  • Receive Date 02 February 2013
  • Accept Date 06 April 2022