TY - JOUR
T1 - Profit, payment and pharmaceutical practices
T2 - Perspectives from hospitals in Bangkok
AU - Pitaknetinan, Kitti
AU - Tangcharoensathien, Viroj
AU - Supachutikul, Anuwat
AU - Bennett, Sara
AU - Mills, Anne
N1 - Funding Information:
The research study was supported financially by the European Commission, DGXII under fixed contribution contract No TS3-CT94-0325 (DG12 HSMU). The researchers based in the Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine are further supported by the Department for International Development, Great Britain. We would like to express our thanks to the staff and management of the nine hospitals in Bangkok who permitted us to carry out this survey and assisted with its implementation.
PY - 1999/3
Y1 - 1999/3
N2 - Means by which to improve the quality of care offered in the private sector have received increasing interest. This paper considers the influences upon hospital physician prescribing practices. It presents data on drug management practices and prescribing patterns in a sample of private for-profit, private non-profit and public hospitals in Bangkok. Clear differences emerge in prescription patterns between the different groups of hospitals: public hospitals exhibit greater use of essential drugs and generic prescribing than either group of private hospital, and prescriptions at private for-profit hospitals tended to have more essential drugs and drugs prescribed by generic name than non-profit hospitals. Prescribing patterns in public hospitals are probably largely explained by national government policy on pharmaceutical procurement. In contrast, prescribing patterns in private for-profit hospitals appear heavily influenced by pressure upon management to contain costs, in circumstances where high drug costs cannot be passed on to purchasers. Hence hospital management have developed policies encouraging the use of generic drugs and essential drugs. These same financial pressures also explain some less desirable forms of behaviour in private for-profit hospitals such as prescribing courses of antibiotic treatment of extremely short duration. Possible measures which government may take to encourage appropriate prescribing within private hospitals are discussed. Copyright (C) 1999 Elsevier Science Ireland Ltd.
AB - Means by which to improve the quality of care offered in the private sector have received increasing interest. This paper considers the influences upon hospital physician prescribing practices. It presents data on drug management practices and prescribing patterns in a sample of private for-profit, private non-profit and public hospitals in Bangkok. Clear differences emerge in prescription patterns between the different groups of hospitals: public hospitals exhibit greater use of essential drugs and generic prescribing than either group of private hospital, and prescriptions at private for-profit hospitals tended to have more essential drugs and drugs prescribed by generic name than non-profit hospitals. Prescribing patterns in public hospitals are probably largely explained by national government policy on pharmaceutical procurement. In contrast, prescribing patterns in private for-profit hospitals appear heavily influenced by pressure upon management to contain costs, in circumstances where high drug costs cannot be passed on to purchasers. Hence hospital management have developed policies encouraging the use of generic drugs and essential drugs. These same financial pressures also explain some less desirable forms of behaviour in private for-profit hospitals such as prescribing courses of antibiotic treatment of extremely short duration. Possible measures which government may take to encourage appropriate prescribing within private hospitals are discussed. Copyright (C) 1999 Elsevier Science Ireland Ltd.
KW - Appropriate prescribing
KW - Drug management
KW - Private hospitals
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U2 - 10.1016/S0168-8510(98)00066-9
DO - 10.1016/S0168-8510(98)00066-9
M3 - Article
C2 - 10351667
AN - SCOPUS:0032966272
SN - 0168-8510
VL - 46
SP - 179
EP - 194
JO - Health policy
JF - Health policy
IS - 3
ER -