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Background: Chronic kidney disease (CKD) exists both as a common cause of hypertension and also a complication of uncontrolled hypertension. This complex interplay of hypertension and CKD further increases the risk of adverse cardiovascular and cerebrovascular outcomes in patients with compromised renal function. Aim and Objectives: The present study tried analyze the characteristics of hypertensive CKD patients and the current antihypertensive treatment pattern in CKD patients in a tertiary care set up in Eastern India. Materials and Methods: A prospective and observational study included adult currently diagnosed CKD patients along with hypertension. Basic demographics along with medical history, blood pressure (BP) measures treatment details, and laboratory information were retrieved for each included patient, noted and analyzed statistically. Results: Around 47% patients were taking two antihypertensives, followed by 19.7% on three and 17.97% on one antihypertensive, respectively, and over 50% patients demonstrating high normal BP, followed by 25% having Grade I hypertension and around 20% having Grade II hypertension. Various classes of antihypertensives prescribed in the present study included calcium channel blockers, beta-blockers, angiotensin receptor blocker, angiotensin-converting enzyme (ACE) inhibitors, centrally acting drugs, alpha-blockers, and diuretics. Beta-blockers were found to be the most prescribed antihypertensives, being prescribed in 92.69% CKD patients. This was followed by calcium channel blockers, centrally acting drugs, alpha-blockers, angiotensin receptor blocker, diuretics, and ACE inhibitor. Utilization pattern of antihypertensive drugs among CKD patients helps with a better glimpse on the status of BP control and related renal outcomes in hypertensive CKD patients. Conclusion: Considering the interplay of hypertension and CKD, it is imperative to essentially treat hypertension robustly to ensure better cardio and renoprotection in these CKD patients. Utilization pattern of antihypertensive drugs among CKD patients helps with a better glimpse on the status of BP control and related renal outcomes in such patients. A rational multidrug antihypertensive regime can help achieve better patient outcomes in hypertensive CKD patients.
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Objective:Aim of this study is to assess the drug utilization pattern of cardiovascular drugs in cardiology outpatient department (OPD). Methodology:This prospective, multicenter, cross-sectional observational study was conducted at three selected tertiary care hospitals from different regions in South India. A total of 1026 prescriptions of the patients attending cardiology OPD of these selected hospitals 342 each over a period of 12 months was randomly identified and included in this study then critically analysed for WHO/INRUD core prescribing indicators. Results:Medicines prescribed from NLEM were 89.27%, average drugs prescribed was 5, medicinesprescribed by its generic name were 2.33% and encounters with an injection prescribed were 14.52%. Commonly prescribed different class of drugs for CVDs patients were Anti-platelets (67.73%) followed by Statins (62.57%), Beta blockers (49.51%), ACE-inhibitors (40.93%), Angiotensin receptor blockers (30.40%), Calcium channel blockers (30.11%), Nitrates (25.34%), Diuretics (20.56%), Anticoagulants (20.27%), Vasodilators (9.94%) rest of the cardiovascular drugs were prescribed within 0.5-5% only, other class of drugs also prescribed for patients with different comorbidities are Anti-ulcers (69.10%), Opioid analgesics (4.09%), Antacids (3.80%), Anti-emetics and Pro-kinetics (1.85%), a pattern of poly-pharmacy was clearly evident, majority of drugs were prescribed as single drug (86.78%) whereas 13.21% as FDCs. The most commonly prescribed single drug was Aspirin (59.93%) and FDCs were Aspirin + Clopidogrel (40.24%). Anti-thrombotic agents’ particularly antiplatelet drugs expected to overtake anti-cholesterol drugs as the sales leader in the market. Maximum drugs were prescribed from the recent NLEM of India by most of practitioners its shows its acceptance and implementation by the prescribers.Conclusion: Deprescribing PPIs for the non-required patients is suggested to lower the risk of adverse drug interactions and economic burden to patients, also pharmacists needs to encourage the prescriptions with drugs in generic name if it’s deviated from the standards recommended by WHO/INRUD
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Background: Study of prescription patterns is an important to determine rationality of drug therapy and to maximize the utilization of resources. Objective: This prospective, multicenter, cross-sectional observational study was conducted at three selected tertiary care hospitals in South India to assess the drug utilization pattern (DUP) of cardiovascular drugs in outpatient department (OPD). Materials and Methods: A total of 1026 prescriptions of the patients attending cardiology OPD over a period of 1 year were randomly identified then critically analyzed for World Health Organization (WHO) core prescribing indicators. Results: The average number of drugs prescribed was five and medicines prescribed by its generic name were 2.33%, encounters with an injection prescribed (14.52%), medicines prescribed from National List of Essential Medicine (NLEM) were 89.27%, apart from above some other class of drugs also prescribed for patients with different comorbidities. Majority of drugs were prescribed as single drugs (86.78%) whereas 13.21% as fixed-dose combinations (FDCs). The most commonly prescribed single drug was aspirin (59.93%) and FDC were Aspirin + Clopidogrel (40.24%). Most of drugs were prescribed from the recent NLEM of India which indicates the implementation and adoption of national drug policy by the hospitals and cardiologists. Conclusion: Antiplatelets dominated the prescribing pattern in the cardiology OPD and expected to overtake anti-cholesterol agents as the sales leader. Updated knowledge about the banned drugs, irrational FDCs, deleted drugs, and recent NLEM are very important to both practitioners and pharmacists, also pharmacists have to encourage the prescribers to prescribe the cardiovascular drugs by its generic name.
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Genitourinary tract infections are some of the most common infections in females. These problems are a challenge in terms of diagnosis and treatment. The present study was conducted to evaluate the prescribing pattern in three of the most common types of female genitourinary tract infections.METHODSA prospective and observational study was conducted on genitourinary tract infections in female patients at the gynaecology outpatient department in a tertiary care university hospital.RESULTSMajority of the infected female patients were in 26 - 35 years age group (31.8%) followed by 36 - 45 years age group (25.9%). The common infection noticed was urinary tract infection (42.2%), followed by pelvic inflammatory disease (32.2%) and vaginitis (25.5%) in infected female patients. The types of antibiotics prescribed for urinary tract infection were aminoglycosides, fluoroquinolones, cephalosporins and penicillins. The commonly prescribed antibiotics for pelvic inflammatory disease were tetracyclines, azoles, fluoroquinolones and cephalosporins, and for vaginitis azoles and aminoglycosides. The most commonly prescribed class of antibiotics for urinary tract infection, pelvic inflammatory disease and vaginitis were fluoroquinolones (11.8%), azoles (11.8%) and aminoglycosides (15.7%), respectively. Oral route was the preferred mode of administration (71%), followed by rectal (suppositories, 17.2%) and topical (cream, 11.8%).CONCLUSIONSYoung married women in this urban Indian community have a high prevalence of genitourinary tract infections but seldom seek treatment. Education and outreach are needed to reduce the stigma, embarrassment and lack of knowledge related to genitourinary tract infections
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In India, Emergency Obstetric Care services were started under RCH-II with the goal to reduce MMR to less than 100/lakh live births, and increase institutional deliveries to 80% by 2010. Strategy was to enhance availability and access to EmOC, for averting unpredictable death during pregnancy and childbirth. We wanted to determine the perception of beneficiary women about accessibility and utilization pattern of EmOC at peripheral health care facilities. METHODSThe present qualitative study was conducted in one of the eight blocks of Wardha (Maharashtra) from May to October-2017. Data was collected by in-depth interview of service users (21 beneficiaries). Notes were transcribed and then translated into English. Respondents’ verbatim that are significant and illustrative as per theme of study were used for analysis.RESULTSFacilitators for EmOC were found to be birth preparedness, promotion of institutional delivery, registration for JSY/JSSK through health workers along with provision of some EmOC services. Socio-cultural beliefs, leading to delay in recognition of danger signals to access care, transportation delay due to poor access of ambulance and identified vehicles along with insufficient coverage of JSSK program, were the main barriers. Beneficiaries who required EmOC were dissatisfied due to frequent referral & travelling, expenditure on transport & food, loss of daily wages, managing dependent family members and domestic work.
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Background: Chronic kidney disease can progress to end-stage kidney failure (ESRD), which is fatal without artificial filtering (dialysis) or a kidney transplant.Methods: The ESRD patients of either gender age >18 years who were diagnosed by nephrologist as ESRD and are on haemodialysis regularly included for the study.Results: The blood urea, serum creatinine, phosphorous, potassium levels were reduced significantly in post – haemodialysis condition, but, there was not much weight reduction after haemodialysis. Serum albumin, serum sodium and blood haemoglobin levels were almost unchanged in post – haemodialysis state. There was no significant difference between the pre and post haemodialysis parameters- serum Na+ serum albumin and blood hemoglobulin. Out of 75 ESRD patients, almost all patients 74 (98.7%) prescribed tablet Livogen, 73 (97.3%) patients given Inj. EPO, 55 (73.3%) tab Nicardia, 54 (76%) tab Sodamint, 43 (57.3%) capsule Alpha D3, 40 (53.3%) tab Shelcal. While between 12 (16%) to 20 (26%) patients prescribed tab Nodosis, tab Metoprolol, tab Febuget, tab Ecosprin, and tab Rantac. Only 1 (1.3%) to 9 (12%) patients received tablet Augmentin, tab Arkamine, tab Carvedilol, tab Para 500, tab Atorvas, Human mixtard, tab Calcicard, tab Minipress XL, tab Dytor, and tab Clopilet.Conclusions: The available two models of treatment, i.e., haemodialysis and poly pharmacy at hospital setup to face the challenges associated with the ESRD, and even outcome after application of both these two models of therapies did not provide optimal normal healthy life status to ESRD patients.
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Aim & Objective:The study aimed to evaluate the disease pattern, drugs used & the prescribing patterns to the geriatric patients at rural hospital.Materials and Methods: Atotal of 300 patients were enrolled in the prospective, cross sectional study. The demographic details, drugs used condition for which the drugs were prescribed and other related factors; names by which they were prescribed, use of fixed dose combinations were recorded and subjected to analysis. Observation and Results: Enrolled patients belonged to the age between 65 to 74 years, who presented with cardiovascular (21.22%) followed by musculoskeletal conditions (17.44%). Medicines were mostly prescribed by brand names 72.11%, Ranitidine was most frequently prescribed followed by Aceclofenac. About 20.35% were prescribes as FDCs for ex; Aceclofenac + Paracetamol was most commonly prescribed FDC followed by Amoxicillin + Clavulanic Acid.Conclusion: Cautious use of medicines in geriatric patients is essential which can be provided by rational prescribing.
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Background: With the changing lifestyle, the incidence of psychiatric illness is increasing day by day. And the mental illnesses not only affect the social and personal life but also adds additional economic burden affecting quality of life of the person. So, proper diagnosis and management of psychiatric illnesses is utmost important. So, keeping this in mind, the present study has been conducted to evaluate drug utilization pattern of psychotropic medicines in tertiary care centre of Bastar region.Methods: After obtaining approval from Institutional Ethics Committee, present study was conducted in 237 patients for a period of 3 months from February 2019 to April 2019. The data of patients attending psychiatry OPD was collected in a structured case record form. The data were analysed using graph pad prism version 6.0.Results: Out of total 237 patients, males 136(57.38%) outnumbered females 101 (42.62%). The major psychiatric illness reported was schizophrenia (45.99%) followed by bipolar affective disorder (16%) and generalized anxiety disorder (14.35%). Average number of psychotropic drugs per prescription was 1.74±1.02. The percentage of drugs prescribed from state Essential drug List (EDL) was 93.05%.Conclusions: Overall, the principles of rational prescribing was tried to be maintained, as polypharmacy has been avoided and most of the drugs were prescribed from the state EDL. The use of generic drugs should be increased to make prescriptions more rational and to cut down the cost of the therapy which may be helpful in increasing the quality of life of the patients.
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Background: Dengue fever (DF) is a serious public health problem, gaining global attention because of its morbidity and mortality. Less studies on Drug utilization pattern of DF in India. The present study was undertaken to analyze Drug utilization pattern of dengue infection in a tertiary care hospital.Methods: A prospective cross-sectional study was conducted for a period of 2 months in a tertiary care hospital and the data was analyzed by using various drug use indicators.Results: A total of 52 prescriptions were analyzed. Male and female were (46.16%, 53.84%), A total of 330 drugs were prescribed. 86 (26.06%) antibiotics, 70 (21.21%) antipyretics, 51 (15.46%) antacids, 19 (5.76%) multivitamins, 52 (15.76%) anti-emetics and 52 (15.76%) papaya leaf extract was prescribed. 84 (25.46%) oral and 246 (74.54%) injectable drugs. IV-fluids given to all patients. 10 (19.24%) were given blood transfusion. 6.17 drugs per prescription. 96% drugs were prescribed by brand names. High DDD for drugs like diclofenac (184), doxycycline (115), metronidazole (2.5), pantoprazole (161.5), rabeprazole (34.6), ondansetron (200) was observed.Conclusions: Most commonly used drugs are antipyretics, antibiotics, antacids, antiemetic, papaya leaf extract. As the incidence of DF is increasing with epidemics, demand for specific treatment guidelines is in great need. Early recognition of the disease, with a rational approach in case management leads good clinical outcome.
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Background: Drug utilization pattern in pregnancy population provide insights regarding drug profile and interventional measures and also minimizes the inherent risk occurring due to unethical prescription.Methods: It was a prospective cross sectional study where prescription slips were collected. Further drugs were categorized according to the classification defined by US Food and drug Administration for pregnancy. Using Pre validated questionnaire the pregnant women were interviewed and parameters regarding knowledge about antenatal visit and contraception, self-medication practices were noted.Results: Among the total 365 participants, 81.4% had finish their high schooling and were in reproductive age group of 22-25. Study revealed predominant usage category- A drugs in I (95.5%), II (97.8%), III (96.4%) trimester. None of them received Category D or X drugs. Almost 100% and 98.6% in III and II trimester respectively received iron. Other drugs prescribed were calcium, anti-emetics, anti-ulcer, NSAIDS and antimicrobial. The awareness about Intra Uterine Contraceptive Devices and Oral Contraceptive Pills were 48.2% and 31.5% respectively. Unfortunately only 4.9% felt that drug use could be dangerous to foetus. 58.9% were aware about antenatal examination during pregnancy.Conclusions: Evaluation of drug utilization pattern periodically will minimize incidence of risk to foetus and mother during pregnancy.
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Background: Mainstay of management in urinary tract infection (UTI) is antibiotics and it is seen in recent years that antibiotic resistance is increasing. However, very few treatment guidelines exist for UTI and often treating physicians may not adhere to these guidelines. Aims: Current study was undertaken to analyze antimicrobial prescription pattern and utilization, and check for physician adherence to treatment guidelines in UTI.Methods: This retrospective, record-based study was carried out in a tertiary care hospital in inpatients with UTI. Tabulated data was analyzed using WHO core drug prescribing indicators and Anatomical Therapeutic Chemical/ Defined Daily Dose (ATC/DDD) index. Adherence to treatment guidelines was assessed using Indian Standard Treatment Guidelines for Urology. Data documented in SPSS software was analyzed using ?2-test and multinomial logistic regression.Results: Among 364 patients included in study, equal incidence of UTI was seen in both sexes (male to female ratio 1.02:1). Prolonged hospital stay (>7 days) was associated with elderly age group (OR=3.09, CI95% 1.83-5.21), complicated UTI (OR=8.11, CI95% 4.62-14.24), ESBL-producing E. coli (OR=3.07, CI95% 1.58-5.94), non-adherence to treatment guidelines (OR=8.65, CI95% 4.19-17.84), and presence of comorbid conditions like diabetes mellitus (OR=4.89, CI95% 3.05-7.82), benign prostatic hypertrophy (OR=2.76, CI95% 1.36-5.59) and utero-vaginal prolapse (OR=8.33, CI95% 2.28-30.45). Average number of drugs prescribed per encounter was 1.59, while drugs prescribed by generic name and from essential drug list were 98.1% and 70.69% respectively. Majority of prescriptions (87.6%) adhered to standard treatment guidelines. Prescribed daily dose (PDD) and defined daily dose (DDD) were equal for most antibiotics prescribed.Conclusions: Majority of prescriptions were adhering to treatment guidelines but the need to prescribe using generic name and from essential drug list should be emphasised upon.
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Background: Mental disorders are now widely recognized as a major contributor to the global burden of disease. The drug use in psychiatric illness is a complex process and because of this the optimal benefits of drug therapy in patient care is not achieved. This often leads to increased cost of medical care, drug resistance, adverse effects and patient mortality. Hence, this study is undertaken to study the drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of a tertiary care hospital.Methods: A prospective, observational study was undertaken from 1st February 2015 to 31st July 2016. A total of 250 prescriptions were analysed. Defined daily dose of the drugs were calculated. ADR’s were recorded in the format of the National Pharmacovigilance Programme of India (PvPI).Results: In 250 prescriptions most, common drug prescribed was antipsychotics (48.5%). Total drug utilization in terms of DDD/100 bed days was 669. The total number of adverse drug reactions observed was 8%. Antipsychotics were the most common class of psychotropic drugs causing ADR’s.Conclusions: In conclusion, it has been found that the psychotropic drugs used in our psychiatry department was rational and was based on clinical knowledge, expertise and the guidelines available in the field of psychiatric practice.
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Background: Infants and children constitute a large proportion of the population in developing countries. In Gujarat, studies on drug use patterns in the pediatric age group are lacking in the Saurashtra region hospitals. The objective was to study demographical information and the utilization pattern in the in patients of the pediatric ward. Methods: A cross-sectional, observational drug utilization study was carried out over a period of 6 months in 630 pediatric inpatients of the pediatric department of Guru Gobind Singh Hospital, Jamnagar, a tertiary care teaching hospital. Analyzed data included demographic details and drugs prescribed in respective patients. Results: Most commonly affected age group was 1-5 years, boys in 62.06% and girls in 37.94% and 40.16% were admitted in the pediatric ward. Acute gastroenteritis and pneumonia had the highest admission rate with 31.90% and 22.38%, respectively. The majority of children were prescribed 5-6 drugs. Ceftriaxone (64.92%) was the top most frequently prescribed antibiotic, followed by amoxicillin (49.21%). Prescribing drugs were mainly from essential drug list (64.44%) and by generic names (61.89%). Drugs prescribed orally in 66.10% and by injections in 33.90%. Conclusion: It is quite evident that significantly large number of children were from 1 to 5 year age group. The majority of the children were admitted in inpatients of the pediatric ward for acute gastroenteritis, followed by pneumonia and meningitis. Most frequently prescribed antibiotic group was cephalosporin, followed by penicillin group.
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Background: The objective of present study was to assess the drug utilization pattern among the geriatric patients. Methods: Totally, 150 prescriptions of patients’ ≥65 years admitted in the medicine inpatient department of MVJ Medical College and Research Hospital, Hoskote were noted from September 2013 to March 2014 and demographic profile, drug utilization pattern, commonly used drugs as per anatomical therapeutic chemical classification (ATC) and WHO core indicators were assessed after taking informed consent from the patients. Results: Out of 150 patients, average age of geriatric patients was 66.83 years with female preponderance (59%). Maximum number of patients were having respiratory disorders (66.67%) followed by diabetes mellitus (35.3%), and cardiovascular diseases (32.67%). 76% patients had co-morbid diseases like diabetes mellitus (n=53), hypertension (n=49), and chronic obstructive pulmonary disease (n=41). A total of 849 drug formulations, containing 1050 active ingredients, were prescribed with average number of 7 (1050/150) drugs per prescription. Only 70 formulations were prescribed by their generic names, which is less than that prescribed by their brand names 779 and total of 146 (17.19%) drugs were prescribed as fixed dose combinations. Only 45.47% drugs were according to WHO Essential Medicines List. Drugs acting on respiratory system (n=189) were the most commonly used drugs in our study followed by drugs acting on the gastrointestinal system (n=130), antimicrobials (n=113), cardiovascular system (n=112), endocrine (n=83), and nutritional supplements (n=72). Polypharmacy was prevalent in 62% and about 22.67% of patients received <5 drugs. Pantoprazole was most frequently prescribed drug followed by aspirin 75 mg, adrenergic, and anticholinergic bronchodilators. Conclusion: Thus, irrational prescribing and polypharmacy were prevalent among elderly. Drug utilization data can help in assessing the quality of care given to the geriatric patients and promote rational use of medicines.
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Background: Epilepsy is “a condition characterized by recurrent (two or more) seizure, unprovoked by any immediate identifi ed cause.” The desired outcome of antiseizure drug (ASD) therapy is to be seizure-free throughout the rest of life. The objective was to study the utilization pattern and adverse drug reactions (ADRs) associated with the use of ASDs in pediatric outpatients in epilepsy clinic. Methods: This cross-sectional, observational and single center study was carried out over a period of 1 year in 430 pediatric patients. Analyzed data included demographic details and drugs prescribed in respective seizure types along with ADRs due to ASDs. Results: In a total 430 patients analyzed, seizure were most commonly observed in boys (69.8%) in 6-10 year of age (45.3%), with a positive family history in (16%), with no specifi c cause of seizure in (71.6%), with most common type was focal seizure in (62.3%), which was mainly treated with carbamazepine (73.8%). Most common ADR was irritability (32.2%) with Valproate being main drug. 87.3% ADRs were in “ possible” as per World Health Organization causality assessment scale, 94.9% ADRs were “mild” as per Hartwig and Siegel severity assessment scale and 98.3% ADRs were “preventable” as per Schumock and Thornton preventability scale. Conclusion: Focal seizure was most common type of seizure observed mainly in boys of 6-10 year with carbamazepine as mainly prescribed drug. Use of appropriate ASDs in the majority of patients as per guidelines, has decreased number of ADRs in our study. Prescribing drugs were mainly from essential drug list and by generic names.
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Background: In India, a proper reporting of medication errors in the hospital is not available. Drugs worth crores of rupee are consumed every year but a substantial part of these drugs are irrationally prescribed. In order to promote rational drug usage standard policies on use of drugs must be set, and this can be done only after the current prescription practices have been audited. The prescriptions were analyzed based on the objectives of the study in order to promote rational use of drugs in a population. Methods: The study was carried out prospectively over a period of two months and 15 days in general medicine OPD of our tertiary care hospital. A specially designed performa was used with pre-inserted carbons. Results: Two hundred and thirty seven prescriptions were analyzed. Total no. of drugs in 237 prescriptions were 1001. Therefore average number of drugs/prescription is 4.22. Drugs were prescribed by generic names in 3.79% of cases, drugs on EDL are only 53.25% and fixed dose combinations are 26.87% of total drugs. Dosage forms used were mostly oral -93.51%. Injectables were only 6.19% and topical forms were least 0.299%. Doctors profile indicates that maximum number i.e. 93.67% were general practitioners. Basic information of patient was written in 72.57% prescriptions. Complete diagnoses were written in 70.04% prescriptions. Only 88.61% prescriptions were legible and only 76.79% prescriptions were complete in terms of dose, route, strength, frequency and dosage forms. Disease pattern seen was variable. Diseases of respiratory system were maximum 44.72 % followed by infectious and parasitic diseases - 16.03 % and diseases of digestive system - 13.92 %. The most common drug groups prescribed were NSAIDs± serratiopeptidases, antibiotics, antihistaminics, multivitamins, minerals, enzymes and expectorants & bronchodilators. The incidence of polypharmacy was also common with maximum number of drugs which were prescribed per prescription were four in 39.24% of prescriptions. The prescriptions also had other minor anomalies. Conclusions: This study showed that there is scope for improvement in prescribing patterns in areas of writing generic names of drugs, essential drugs, writing legible and complete prescriptions. Polypharmacy was also evident from our study. Establishment and implementation of appropriate clinical guidelines, use of essential medicines list, public education about medicines and regular update to the clinicians will help in implementing the principles of rational pharmacotherapeutics.
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PURPOSE: To investigate utilization patterns and cost of medical treatment of complementary alternative therapy in children with atopic dermatitis. METHODS: A self-reported questionnaire concerning utilization pattern and cost of medical treatment of complementary alternative therapy was completed by 196 children <12-year-of-age diagnosed with atopic dermatitis for over 1 year. Descriptive, t-test, and analysis of variance analyses were performed. RESULTS: About 70% of children reported the use of alternative therapy methods including, in order of frequency, bath, herbal medicine, supplemental foods, aroma therapy, massage, and acupuncture. During the previous 12 months, direct costs for these hospital treatments averaged 596,300 Korean Won (KRW, the currency of South Korea). The time cost averaged 657,000 KRW and transportation expenses averaged 598,000 KRW of indirect cost of hospital treatment. The direct cost for complementary alternative therapy averaged 741,000 KRW. The time cost averaged 340,000 KRW and transportation expenses averaged 810,000 KRW of indirect cost of complementary alternative therapy. There was a statistically significant relationship between direct cost of complementary alternative therapy and family income. CONCLUSION: The cost of complementary alternative therapy exceeded the cost of hospital treatment, and indirect costs exceeded direct costs. Analyses of cost-effectiveness of patient treatment should include complementary alternative therapy.
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Child , Humans , Acupuncture , Aromatherapy , Baths , Dermatitis, Atopic , Herbal Medicine , Massage , Surveys and Questionnaires , TransportationABSTRACT
PURPOSE: The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. METHODS: We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. RESULTS: The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father(10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. CONCLUSION: Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.
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Adult , Child , Humans , Growth and Development , Hospitals, Pediatric , Internal Medicine , Patient Selection , Pediatrics , Pharmacy , Poisoning , Prevalence , Surveys and QuestionnairesABSTRACT
PURPOSE: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find possible factors influencing the onset and the course of the disorder. METHOD: We performed questionnaires in Kwangju on children from two primary schools from June, 1 1998 to June 30 and carried out statistical analysis. RESULT: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02 : 1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor, The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as infernal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. CONCLUSION: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.
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Adult , Child , Female , Humans , Male , Abdomen , Abdominal Pain , Burns , Chest Pain , Abdominal Pain , Dizziness , Growth and Development , Headache , Incidence , Internal Medicine , Meals , Muscle Cramp , Pediatrics , Pharmacy , Pupil , Surveys and Questionnaires , VomitingABSTRACT
The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follow: The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days, 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.