National health insurance scheme improves access and optimization of antimicrobial use in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

IF 1.9 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2024-03-04 DOI:10.1093/trstmh/trad083

Temitope O Obadare, Taiwo O Ogundipe, Adeyemi T Adeyemo, Caleb M Aboderin, Doyin R Abiola, Naheemot O Sule, Aaron O Aboderin

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Abstract

Background: Nigeria instituted the National Health Insurance Scheme (NHIS) for universal health coverage. This study compared the NHIS and out-of-pocket (OOP) antibiotic prescribing with the World Health Organization (WHO) optimal values.

Methods: A total of 2190 prescription forms from the NHIS and OOP were included in this study conducted at Obafemi Awolowo University Teaching Hospitals Complex, Nigeria from January 2021 to December 2022 and analysed using WHO drug prescribing guidelines.

Results: The average number of drugs per encounter was higher in the NHIS prescribing (χ2=58.956, p=0.00) than in OOP prescribing. The percentage of encounters with an antibiotic prescribed is higher in NHIS prescribing (χ2=46.034, p=0.000) than in OOP prescribing. The percentage of parenteral antibiotic prescribing is higher in OOP prescribing (χ2=25.413, p=0.000) than in NHIS prescribing. The percentage of antibiotic prescribed from the National Essential Medicine List is higher in NHIS prescribing (χ2=8.227, p=0.000) as well as the antibiotics prescribed from the Access category of the WHO Access, Watch and Reserve (AWaRe) Classification of antibiotics (χ2=23.946, p=0.000) when compared with OOP prescribing.

Conclusions: Prescribing indicators show better performances with NHIS antibiotic prescribing and are closer to the WHO-recommended optimal values than in OPP prescribing. Hence NHIS prescribing can be an easy target for hospital antibiotic stewardship intervention for optimal antibiotic prescribing.

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国家健康保险计划改善了尼日利亚Ile-Ife的奥巴费米·阿沃洛沃大学教学医院综合医院获得和优化抗微生物药物的使用。

背景:尼日利亚制定了全民健康保险计划(NHIS)。本研究比较了NHIS和自费抗生素处方与世界卫生组织(WHO)的最优值。方法:本研究于2021年1月至2022年12月在尼日利亚奥巴费米·阿沃洛沃大学教学医院进行，共收集NHIS和OOP的2190张处方表格，并使用世卫组织药物处方指南进行分析。结果:NHIS处方平均每次就诊药品数量高于OOP处方(χ2=58.956, p=0.00)。NHIS处方中抗生素接触率高于OOP处方(χ2=46.034, p=0.000)。面向对象处方的抗生素处方率高于NHIS处方(χ2=25.413, p=0.000)。全国卫生系统处方中使用《国家基本药物清单》抗生素的比例(χ2=8.227, p=0.000)高于使用《世界卫生组织抗生素获取、监测和储备分类》(AWaRe)可获取类抗生素的比例(χ2=23.946, p=0.000)。结论:与OPP处方相比，NHIS处方指标表现更好，更接近who推荐的最佳值。因此，NHIS处方可以成为医院抗生素管理干预的一个简单目标，以获得最佳的抗生素处方。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transactions of The Royal Society of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.00

自引率

9.10%

发文量

115

审稿时长

4-8 weeks

期刊介绍： Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.