RESUMO
At Anjo Kosei Hospital, all staff has been working concertedly on a project to establish a community hospital in line with our future vision. Hospital staff in charge of the Medical Affairs Division has been involved in measures aimed at achieving the slogan “health and happiness of local residents” as part of this project. To address this, three goals were set as follows: improvement of recoveries in accounts receivable management, a reduction of money held in trust, and a decrease in the number of outsourced transactions. To achieve the goals described above, the following specific measure were carried out: (1) collection of accounts receivable using convenience store settlement; (2) collection of high-cost medical expenses by wider use of Eligibility Certificates for Ceiling-Amount Applications and promotion of the Major Medical Cost Loan System for national health insurance holders; and (3) support in acquiring family registration for nonregistered family members and for health insurance benefits. Recoveries of accounts receivable through convenience store settlement was about 90,000 yen/month, and our support activities for family registration and health insurance benefits provided the recoveries of about 80,000 yen/month. Furthermore, the promoted use of the certificate and loan system resulted in recoveries of about 17 million yen/year. The average commission fee and number of outsourcing was 890,188 yen and 12 cases, respectively, from April to August 2016. However, in 2017, it was 305,615 yen and 10 cases, respectively. Our project aimed at achieving slogan-elicited patient voluntary payment of medical expenses, leading to improved recoveries, with reduced money held in trust and fewer outsourced transactions.
RESUMO
<b>Objective: </b>Instructions contained in over-the-counter medicine package inserts can be hard to read because of the limited printing space. Pictograms are one means of helping users to understand important information. However, few pictogram systems have been reliably and validly evaluated. Therefore, a new method was developed to improve the clarity of each illustration and the legitimacy as a pictogram for conveying information important.<br><b>Methods: </b>Four creators developed 69 illustrations, each of which expressed one of 24 instructions in the package insert of an H2 blocker. In a survey, participants (449 university undergraduate and graduate students and 103 pharmacy users) were asked to describe the possible meaning of each illustration and to provide their personal suggestions for improvement. To evaluate comprehension of information, each instruction was broken into two or three different parts. Comprehension level was calculated by: (number of people who answered correctly) × 100 / (total number of respondents). Existing pictograms were included to compare comprehension levels for the same instructions.<br><b>Results: </b>Using 67% as the minimum standard for comprehension, we classified each illustration into one of three categories: “no need for improvement,” “need for partial improvement,” and “need for total improvement.” The students and pharmacy users tended to accurately interpret the possible meanings of illustrations that were familiar to them.<br><b>Conclusion: </b>Breaking one instruction of the package insert into a few important pieces of information was useful for determining the level of improvement needed for each illustration. Evaluating how well each illustration conveys important information in the instructions through two steps was also beneficial, which are to improve the illustration’s clarity with students and its legitimacy among pharmacy users for fulfilling the intended functions of a pictogram.
RESUMO
<b>Objective: </b>It is unclear whether the importance of the healthcare professional’s role and the relationship between healthcare users and providers are well understood in self-medication (SM) practices. We conducted a self-report survey to examine how the role of healthcare professionals in SM is interpreted and how the reciprocal relationship between consumers and pharmacists in SM is recognized.<br><b>Design: </b>Questionnaire survey.<br><b>Methods: </b>The sample comprised 493 medical professionals (283 pharmacists at hospitals, community pharmacies, and drug stores; 74 instructors at colleges of pharmacy; and 136 personnel of SM-related academic societies). We mailed questionnaires with informed consent forms from September to November, 2014; those who agreed to participate mailed completed questionnaires back. We examined how individuals define and interpret SM, clarified each role of pharmacists and consumers regarding several aspects of SM, and collected respondents’ demographic information.<br><b>Results: </b>Of the 493 questionnaires mailed, 125 (25%) were returned. Over 65% of respondents reported familiarity with the preexisting definitions of SM that include the healthcare professional’s role. However, when asked to define SM in their own words, only 30% included the role of healthcare professionals. Among respondents who were not engaged in SM-related research, education or promotion, only 24% included the healthcare professionals’ role. Also, when asked to describe the concrete roles of both pharmacists and consumers, respondents wrote fewer comments on improving living habits, consulting about health concerns, and implementing self-checks than on serving consumers with over-the-counter drugs and health foods.<br><b>Conclusion: </b>The importance of reciprocal relationships in SM was not well recognized in our sample. Our results suggest that it is imperative to disseminate information to raise healthcare professional’s recognition on the importance and clarification of some or all roles of theirs in SM.