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评估埃塞俄比亚中部哈迪亚地区选定公共卫生机构的药品浪费规模及其影响因素。

Assessment of magnitude of medicines wastage and the contributing factors in selected public health facilities of Hadiya Zone, Central Ethiopia Regional State.

机构信息

Department of Pharmacy, Medicine Supply Chain Management Unit, College of Medicine and Health Sciences, Wachemo University, Hossaena, Ethiopia.

Department of Pharmacy, Medicine Analysis and Regulatory Affairs Unit, College of Medicine and Health Sciences, Wachemo University, P.O. BOX: 667, Hossaena, Ethiopia.

出版信息

BMC Public Health. 2024 Oct 24;24(1):2952. doi: 10.1186/s12889-024-20229-x.

Abstract

BACKGROUND

Medicine wastage occurs when medicines are damaged, obsolete, or expired and become unsafe for use. In Ethiopia, although there are reports that reveal the presence of wasted medicines in the country, there is limited objective evidence on the type and extent of medicine wastage as well as its contributing factors.

OBJECTIVE

The study aimed to assess the medicine wastage rate and identify its contributing factors in the sampled public health facilities (HFs) in Hadiya Zone, Central Ethiopia Regional State.

METHOD

A facility-based cross-sectional study complemented by a qualitative study was conducted in selected public HFs in Hadiya Zone, Central Ethiopia Regional State, from November 1 to 31, 2022. All the hospitals were selected intentionally, and health centers were selected using simple random sampling techniques. For the qualitative study, the chief clinical officers and pharmacy department heads of HFs were purposefully selected as key informants because they were supposed to be more information-rich than other health professionals. The quantitative data were entered and analyzed using the Statistical Package for Social Sciences version 20.

RESULT

The total monetary value of wasted medicines in the assessed HFs in the Ethiopian Fiscal Year (EFY) 2011-2013 was 652,479.45 ETB (5.24%). The three-year trend showed that, in the 2011-2012-2013 EFY, medicine wastage was 7.57%, 6.44%, and 3.1%, respectively. Expiration solely accounted for 97.3% of this total value. The alleged explanations for the waste of such medicines were a lack of accurate data available for medicine quantifications, the presence of overstocked medicines due to improper forecasting, a lack of electronic stock management, an abrupt change in the treatment regimen, and improper use of stock management. Whether the perceived causes had an impact on the medicine wastage was assessed, and the results confirmed that a significant association between medicine wastage and overstock (p-value = 0.006, AOR = 8.57, 95% CI = 1.87-39.26), accurate data (p-value = 0.013, AOR = 5.43, 95% CI = 1.42-20.76), and electronic stock management (p-value = 0.05, AOR = 0.311, 95% CI = 0.094-1.03) was observed.

CONCLUSION

The identified medicine wastage rate is significant for a nation that struggles to allocate limited resources fairly. It may negatively affect the initiatives taken by the government to increase public engagement in the healthcare system through insurance contributions. It is a glance for HFs to take immediate corrective action.

摘要

背景

当药品损坏、过期或失效而变得不安全使用时,就会发生药品浪费。在埃塞俄比亚,尽管有报告显示该国存在浪费药品的情况,但关于药品浪费的类型和程度及其促成因素的客观证据有限。

目的

本研究旨在评估抽样公共卫生设施(HFs)中药物浪费率,并确定其促成因素,该研究在埃塞俄比亚中央州哈迪亚地区进行。

方法

2022 年 11 月 1 日至 31 日,在哈迪亚地区的选定公共 HFs 中进行了基于设施的横断面研究,并辅以定性研究。所有医院均采用意向选择,而卫生中心则采用简单随机抽样技术选择。对于定性研究,选择 HFs 的首席临床官和药房部门负责人作为关键信息提供者,因为他们应该比其他卫生专业人员提供更丰富的信息。使用社会科学统计软件包(SPSS)版本 20 对定量数据进行录入和分析。

结果

在埃塞俄比亚财政年度(EFY)2011-2013 中,评估 HFs 中浪费药品的总货币价值为 652,479.45 埃比尔(5.24%)。三年趋势显示,2011-2012-2013 EFY 年,药品浪费分别为 7.57%、6.44%和 3.1%。仅过期就占了该总额的 97.3%。对浪费这些药品的解释是缺乏药品定量的准确数据、由于预测不当而导致库存积压、缺乏电子库存管理、治疗方案的突然变化以及库存管理不当。评估了是否认为造成浪费的原因会对药品浪费产生影响,结果证实,药品浪费与库存过剩(p 值=0.006,AOR=8.57,95%CI=1.87-39.26)、准确数据(p 值=0.013,AOR=5.43,95%CI=1.42-20.76)和电子库存管理(p 值=0.05,AOR=0.311,95%CI=0.094-1.03)之间存在显著关联。

结论

对于一个努力公平分配有限资源的国家来说,确定的药品浪费率是显著的。这可能会对政府通过保险缴费增加公众参与医疗保健系统的举措产生负面影响。这是 HFs 采取立即纠正措施的一个警示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaa2/11515323/729fdeecffd8/12889_2024_20229_Fig1_HTML.jpg

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