Ferrinho P, Valli A
Department of Tropical Public Health, Universidade Nova de Lisboa, Portugal.
Ann Soc Belg Med Trop. 1994 Dec;74(4):327-38.
This report provides an analysis of expenditure on pharmaceuticals at the Alexandra Health Centre and University Clinic (AHC), South Africa. Drug costs increased at a rate higher than for the general expenditure budget. The drug cost per script per department varied from R9.43 for patients attending the diabetic clinic to R0.60 for antenatal care patients. In general, female consultations at the adult outpatient department (AOPD) were more expensive than male's and adult's more than paediatric's. The largest share of drug costs went to adult female patients in AOPD and the smallest share went into preventive and promotive care services. Again the same observations apply for drug costs as percentage of the total costs per clinical department. This study shows that drug costs were a significant contributor to the level of primary health care (PHC) expenditure. We discuss the alternatives to cost-recovery in a concrete situation like the peri-urban community being served by the AHC. It is concluded that in communities similar to Alexandra it would be possible to provide PHC at about R30 per capita per annum with about 15% being spent on pharmaceuticals.
本报告对南非亚历山德拉健康中心及大学诊所（AHC）的药品支出进行了分析。药品成本增长速度高于总体支出预算。每个科室每张药方的药品成本各不相同，糖尿病诊所患者的每张药方成本为9.43兰特，而产前护理患者的每张药方成本为0.60兰特。总体而言，成人门诊部（AOPD）女性患者的诊疗费用高于男性，成人患者的诊疗费用高于儿科患者。药品成本的最大份额用于AOPD的成年女性患者，最小份额用于预防和促进保健服务。每个临床科室的药品成本占总成本的百分比也有同样的情况。本研究表明，药品成本是初级卫生保健（PHC）支出水平的一个重要组成部分。我们讨论了在AHC所服务的城郊社区这样的具体情况下实现成本回收的替代方案。得出的结论是，在与亚历山德拉类似的社区，每年人均约30兰特就有可能提供初级卫生保健，其中约15%用于药品。
