Jones N, Purdie G
Department of Community Health, Wellington School of Medicine.
N Z Med J. 1993 Jun 9;106(957):225-6.
The study aimed to examine the impact of user charges on the dispensing of prescription medicines. The effect of social class, customer type and number of items on the incidence of payment problems was examined.
The study employed a two week survey of 26 pharmacies randomly selected from Wellington Pharmacy Guild. Pharmacists completed a questionnaire on each occasion user charges led to a problem dispensing a prescribed medicine. Data collected included: type of problem encountered and its outcome, customer information (including the customer's pharmaceutical benefit category), and prescription information (including the number of items prescribed).
The overall incidence of payment problems was 1.5% or 1 in every 66 prescription forms processed by the pharmacists. User charges resulted in medicine dispensing failure on 56% of the problem occasions. Customers incurred debt or were funded by a social agency on the remaining 44% of problem occasions. Fifty-three percent of dispensing failures resulted in non-collection of items at the end of the survey period. Thirty-four percent of debts were outstanding at the end of the survey. The incidence of all payment problems correlated with the social "need" score of the pharmacy area and was significantly higher for children's and student's prescriptions.
User charges may provide a greater barrier to children, students and people living in areas of high social need. Ongoing evaluation of the impact of user charges is required to ensure improved prescribing is achieved equitably [corrected].
本研究旨在探讨使用者付费对处方药配药的影响。研究了社会阶层、顾客类型和药品数量对支付问题发生率的影响。
该研究对从惠灵顿药剂师公会随机选取的26家药店进行了为期两周的调查。每当使用者付费导致配药出现问题时，药剂师需填写一份问卷。收集的数据包括：遇到的问题类型及其结果、顾客信息（包括顾客的药品福利类别）以及处方信息（包括所开药品的数量）。
支付问题的总体发生率为1.5%，即药剂师处理的每66份处方中有1份出现问题。在出现问题的情况中，56%是由于使用者付费导致药品配药失败。在其余44%的问题情况中，顾客产生了债务或由社会机构提供资金支持。在调查期结束时，53%的配药失败导致药品未被取走。在调查结束时，34%的债务仍未偿还。所有支付问题的发生率与药店所在区域的社会“需求”得分相关，儿童和学生处方的发生率显著更高。
使用者付费可能对儿童、学生以及生活在社会需求较高地区的人群构成更大障碍。需要对使用者付费的影响进行持续评估，以确保在公平的基础上实现更好的处方开具[已修正]。
