Identification of drug cost reduction opportunities in a university hospital in Saudi Arabia

Expenditure on medications represents significant proportion of the total hospital budget. Establishing an effective drug cost management program is a priority area for hospitals that must begin with determining the current costs and pattern of use of medications. The aim of the present study is to determine the cost and pattern of drug utilization at the study hospital in order to identify cost reduction opportunities. A descriptive retrospective design was used to examine the cost and pattern of drug utilization for all admissions during the period from: 1[st] January 2006 to 30[th] June 2006 in an university hospital in Eastern Saudi Arabis. Electronic patient data as well as manual drug cost data were obtained and merged to create the analysis database. The study revealed that the total drug cost at the study hospital was SR 11, 823, 666.9 [mean per admission=SR 2123.5 and median per admission=SR 357.3] during the study period. Antibiotics were responsible for 35.8% of the total inpatient drug costs followed by blood products which accounted for 20.6% of the total inpatient drug costs. Further investigation of both groups revealed that the combination of piperacillin and tazobactam represented 4.5% of prescribed drugs and accounted for almost half of the inpatient ntbiotic costs [SR 2, 064, 916.8] and 17.4% of the total hospital's inpatient drug costs. Human alumin and intravenous immunoglobulin were responsible for the majority of cost of blood products. Piperacillin and tazobactam, human albumin, and intravenous immunoglobulin other than Rho [D] immunoglobulin are responsible for high percentage of drug expenditure at the study hospital while being prescribed to a limited number of patients. Designing a drug cost management program to target these three drugs will increase the likelihood of achieving significant cost reduction

Patient preference for providers' gender at a primary health care setting in Alexandria, Egypt

The aim of this study is to determine patient's gender preferences in choosing general practitioners and specialists for both general and specific health issues at primary health care centers in Alexandria, Egypt. A descriptive cross-sectional study was conducted at Smouha Health Center, Alexandria Governorate, Alexandria, Egypt. The study was conducted between the period January - March 2004. A pre-designed questionnaire was used. The format included 3 main sections, namely, socio-demographic, beliefs towards provider's gender, and providers' preferences of patients. Both male and female patients preferred a male physician for consultation and clinical management of cases. The highest percentage of male patients [81.4%] and female patients [41.0%] preferred physician of the same gender, and such preference was of personal reasons for males [97.9%] and females [96.6%], while basing on traditions and norms for male [62.9%] and female [63.4%]. Significant results of the stepwise logistic regression analysis in relation to socio-demographic factors on provider preference revealed that job and income were the significant determinants of gender preference for the sample under study. Patients prefer physicians of the same gender, but in actual practice a male physician is believed to be more competent

Women health in poor urban settings in Alexandria

The aim of this paper is to investigate women health and status as well as to study gender gap in three poor urban settings in Alexandria. Poor families were identified and invited to participate in the study through the help of local informants. The study included 172 families, 53 from Abu- Kir, 57 from El-Dahreya and 62 from Wadi El-Kamar area. An interviewing questionnaire was used to collect data form the wives as well as their husbands about household family members. Wives and husbands who participated in the study were clinically examined. Their weight and height were measured. For those who accepted to participate, stool, urine and blood analyses were performed. Female to male comparison as well as sex ratio of some parameters were used to investigate gender gap. Results showed that females were the head of the family in 19.8% of the families. In 18% of the families, wives participated in the family income. Illiteracy represented 94.2% among females aged 45+ years, and unemployment was 97.4%. The rate of ill health increased with age from 36% for girls to 90% among older women [45+] compared to 71% among older males. Cardiovascular and orthopedic disorders represented the most reported problems among older females and males. Diarrhea and ARI episodes were rather more frequent among females than among males. About 60% of examined women suffered from obesity, 45% had gynecological problems, 38% had parasitic infections in stool, and 45% had anemia. Female to male sex ratio was low for <6 and 60+ years old. In conclusion, poor women suffer from high burden of socio-economic disadvantage, gender inequality and ill-health

Risk factors of puerperal sepsis in Alexandria

Puerperal infections are an important cause of maternal morbidity and mortality in developing nations. Investigators have noted several risk factors for developing puerperal sepsis. However, the relative importance of these risk factors varies and has to be determined for each setting. Therefore the aim of the present work was to determine the risk factors for puerperal sepsis in Alexandria, Egypt. A case-control design was used to study the risk factors of puerperal sepsis in Alexandria. The study included 160 puerperal sepsis cases and 160 controls. Puerperal sepsis cases were recruited from the fever hospital as well as from 3 rural health units and three urban health offices in Alexandria. A pre-designed interviewing questionnaire was used to collect data about risk factors of puerperal sepsis. Logistic regression analysis indicated that very low socio-economic score [OR=6.4], no ANC [OR= 4.5], delivery at a governmental maternity hospital [OR= 203.4], frequent vaginal examinations [OR=5.1], anemia during puerperium [OR= 4.3], unsanitary vaginal douching during puerperium [OR=19.9] and unhygienic preparation of diapers used immediately after delivery [OR= 12.1] were significantly related to the occurrence of puerperal sepsis. Improving infection control measures during delivery, limiting the frequency of vaginal examinations, and avoiding all unhygienic practices related to delivery are strongly recommended