Abstract:
Background: Analyzing purchased health commodities based on their budgetary consumption and importance is crucial for efficient utilization of a hospital\'s budget. However, it is rarely seen when hospitals, mostly in developing countries, conduct such kinds of analyses and make an informed decision, including to utilize their limited budget efficiently. Therefore, the purpose of this study was to analyze a 3-year inventory of health commodities (medicines, medical supplies, and laboratory reagents and chemicals) in Saint Paul Hospital Millennium Medical College (SPHMMC). Methodology: The study was conducted in SPHMMC located in Addis Ababa, Ethiopia. It is one of the largest specialized public hospitals in the country. It is a huge teaching hospital in the country where a large amount of budget is utilized. Three years of data were collected and ABC, VEN, and ABC-VEN matrix techniques were applied for the analysis. The data collection period was from March to April 2017. Results: An average of 296 medicines, 194 laboratory commodities, and 105 medical supplies were purchased over 3 years. Class A medicines, which consume 80% of the total annual pharmaceutical expenditures (APE) account, are 17.8%-20% of the total medicines by quantity. Antibiotics (ceftriaxone 1 gm injection and metronidazole), IV fluids (sodium chloride 0.9% injection and dextrose 40% injection), and antidiabetic medication (insulin zin suspension and metformin) are among the top 10 medications by value that consume significant amounts of the budget of the hospital. On VEN analysis, an average of 24% of the items were vital, 67% were essential, and 4-8-8.9% were nonessential. Nonessential items consumed 0.49%, 9.9%, and 1.1% of Annual Expenditures (AEs) in 2013/14, 2014/15 and 2015/16, respectively. On ABC-VEN matrix analysis, a single expensive and nonessential medicine (valganciclovir HCL 450 mg tablet) consumed 9.4% of expenditure in 2014/15. Class A laboratory commodities, which consume 70%-80% of the total laboratory expenditures represented 8.5%-20% of the total laboratory commodities analyzed for the 3 years. From class A items, antimonoclonal antibodies in 2013/14, hemocue glucose 201 4 × 25 tests in 2014/15, and glucose tests in 2015/16 consumed the highest percentages: 9.2%, 8.2%, and 23.7% of the AEs, respectively. There were laboratory commodities procured out of the VEN list, and these accounted for 6.8%-31.2% of the total laboratory expenditures over the 3 years. Class A medical supplies, which consumed 80% of the total medical supply expenditures, represented only 8.2%-15.8% of the total items over the 3 years studied. Surgical gauze 90 cm × 100 m, surgical gloves sterile latex number 7.5, and examination gloves were the top three based on expenditures in all the studied years. In 2015/16, examination gloves alone consumed 71.9% of the total expenditure. Conclusion: SPHMMC manages large numbers of health commodities (more than 500 excluding program commodities) which necessitate efficient inventory management practice in place. However, the purchase of the commodities particularly those products used for laboratory diagnosis is not strictly based on the hospital\'s VEN list, indicating the need for better communication of the laboratory unit with the Drug and Therapeutic Committee (DTC) of the hospital. The DTC of the hospital should update the VEN list of the health commodities and strictly enforce the hospital procurement to adhere to the agreed upon list of medicines. In addition, the hospital should prioritize and decide the quantity and frequency of ordering health commodities based on regular ABC-VEN results.
摘要:
背景:根据预算消费和重要性分析购买的健康商品对于有效利用医院预算至关重要。然而,很少见,当医院,主要在发展中国家,进行此类分析并做出明智的决定,包括有效利用他们有限的预算。因此,这项研究的目的是分析为期3年的保健品清单(药品,医疗用品,以及实验室试剂和化学品)在圣保罗医院千年医学院(SPHMMC)。方法:该研究是在位于亚的斯亚贝巴的SPHMMC中进行的,埃塞俄比亚。它是全国最大的专科医院之一。这是一个巨大的教学医院在该国,大量的预算被利用。收集了三年的数据,ABC,VEN,采用ABC-VEN矩阵技术进行分析。数据收集期为2017年3月至4月。结果:平均296种药物,194个实验室商品,在3年内购买了105个医疗用品。A类药物,消耗了年度药品总支出(APE)的80%,按数量计算,占药品总量的17.8%-20%。抗生素(头孢曲松1克注射液和甲硝唑),静脉输液(氯化钠0.9%注射液和葡萄糖40%注射液),和抗糖尿病药物(胰岛素锌悬浮液和二甲双胍)是按价值计算的前10种药物之一,这些药物消耗了医院的预算。在VEN分析中,平均24%的项目是至关重要的,67%是必需的,4-8-8.9%是非必需的。非必需品消耗0.49%,9.9%,2013/14年度、2014/15年度和2015/16年度分别占年度支出(AE)的1.1%。在ABC-VEN矩阵分析中,2014/15年度,单一的昂贵且非必需的药物(盐酸伐更昔洛韦450mg片剂)消耗了9.4%的支出.A类实验室商品,消耗实验室总支出的70%-80%,占3年分析的实验室商品总额的8.5%-20%。从A类物品中,2013/14年度抗单克隆抗体,2014/15年度血糖2014×25测试,2015/16年度血糖测试消耗百分比最高:9.2%,8.2%,和23.7%的不良事件,分别。从VEN清单中采购了一些实验室商品,这些占3年实验室总支出的6.8%-31.2%。A类医疗用品,消耗了医疗供应总支出的80%,在3年的研究中,仅占总项目的8.2%-15.8%。手术纱布90cm×100m,根据所有研究年份的支出,外科手套无菌乳胶号7.5和检查手套是前三名。在2015/16年度,仅检查手套就占总支出的71.9%。结论:SPHMMC管理大量健康商品(超过500种,不包括计划商品),这需要有效的库存管理实践。然而,购买商品特别是那些用于实验室诊断的产品不是严格基于医院的VEN清单,表明实验室单位需要与医院的药物和治疗委员会(DTC)进行更好的沟通。医院DTC应更新保健品VEN清单,严格执行医院采购,以遵守商定的药品清单。此外,医院应根据常规ABC-VEN结果,确定订购健康商品的数量和频率。