Asenso-Okyere W K, Osei-Akoto I, Anum A, Adukonu A
Institute of Statistical, Social and Economic Research, University of Ghana, Legon, Ghana.
Trop Med Int Health. 1999 Aug;4(8):586-93. doi: 10.1046/j.1365-3156.1999.00438.x.
This qualitative study aimed to assess possible changes in prescription patterns and resultant implications for the quality of care delivered in three southern districts of Ghana after the introduction of a full cost recovery scheme for drugs in 1992. While the availability of safe and effective drugs has improved especially in rural areas, not all patients are able to meet the cost for required medication. This has influenced the behaviour of most prescribers, who now take economical limitations into account. As a result, poorer patients may either take fewer drugs or smaller quantities than medically indicated, with possible ensuing consequences for public health. Overall, the cash-and-carry scheme does not appear to have changed health workers' attitudes towards patients; where such behavioural changes occurred they seemed to be due to personnel shortages. Generally, patients in rural facilities reported greater satisfaction with the care they received than urban residents; and medical assistants were perceived as friendlier than both nurses and doctors.
这项定性研究旨在评估1992年加纳南部三个地区实施药品全额成本回收计划后，处方模式可能发生的变化以及对所提供医疗服务质量的影响。虽然安全有效药物的可及性有所改善，尤其是在农村地区，但并非所有患者都能承担所需药物的费用。这影响了大多数开处方者的行为，他们现在会考虑经济限制因素。结果，较贫困的患者可能服用的药物比医嘱少或剂量小，这可能会对公众健康产生影响。总体而言，现购自运计划似乎并未改变卫生工作者对患者的态度；在出现此类行为变化的地方，似乎是由于人员短缺。一般来说，农村医疗机构的患者对所接受的护理的满意度高于城市居民；人们认为医疗助理比护士和医生更友好。
