International Journal of Health Economics and Policy

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Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh

Received: 23 January 2017    Accepted: 11 July 2017    Published: 11 October 2017
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Abstract

The health sector of Bangladesh registered a significant improvement since the independence of Bangladesh in 1971. Life expectancy at birth which is one of the indicators of economic development increases to 70.65 years in 2014 from 46.88 years in 1972. Nevertheless, misuse of drugs is a common phenomenon in Bangladesh. This study is an attempt to investigate irrational use of drugs, health care level and healthcare expenditure in Bangladesh. The study uses simulated patients and they behaved like ordinary patients when they visited the doctors and collected prescriptions from them. The study finds that there exists a high rate of incorrect diagnosis and inappropriate prescription of drug(s) considering that 82.2% of patients were given more than 2 drugs and 71.2% patients were prescribed antibiotics drug. The rate indeed is very high especially when we consider the fact that the patients were simulated ones with good health. They just pretended being sick. In case of taking physical examination of patients, the situation is worse though the situation at sub-district levels and Dhaka urban area is much better than that in public hospitals. Study finds that cost of drugs per prescription is highest at sub-district level being TK. 301.81 and lowest at Dhaka urban area being TK. 265.20. In public hospital the cost is TK. 232.97 which appears higher than one would expect. All of these impose unnecessary costs on the patients’ healthcare expenditure, increase indebtedness due to income loss, and even employment. Thus, the illness and its related caring expenditures and consequent impacts can severely disrupt living standards. The national policies should emphasize the poverty reduction strategies through improved healthcare status of the country which will ultimately contribute to sustainable development.

DOI 10.11648/j.hep.20170204.12
Published in International Journal of Health Economics and Policy (Volume 2, Issue 4, December 2017)
Page(s) 152-158
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Drugs, Misuse, Healthcare, Healthcare Expenditure, Life Expectancy

References
[1] The World Bank Press Release, 2015.
[2] Bangladesh Bureau of Statistics (BBS), 2015. Annual Report.
[3] Doorslaer E. V., O’Donnell O., Rannan-Eliya R. P., Somanathan A., Adhikari S. R., Garg C. C., Zhao Y. (2006). Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data. The Lancet, 368(9544): 1357– 1364.
[4] Doorslaer E. V., O’Donnell O., Rannan-Eliya R. P., Somanathan A., Adhikari S. R., Garg C. C., Zhao Y. (2007). Catastrophic Payments for Health Care in Asia. Health Econ, 16 (11): 1159– 1184.
[5] Curriea, J., Linb, W., and Zhang, W. (2011). Patient knowledge and antibiotic abuse: Evidence from an audit study in China. Journal of Health Economics, 30 (5): 933-49. doi: 10.1016 /j.jhealeco.2011.05.009.
[6] Sun, Q., Yin, J., Zuo, G., and Meng, Q. (2008). The irrational use of drugs in rural China: evidences from two provinces. Center for Health Management & Policy, Shandong University.
[7] Karmakar, P., and Sattar, M. M. (2012). Antibiotic prescribing pattern in Bangladesh. Bangladesh J. Prog. Sci. & Tec., 10(1): 013-016.
[8] Drug Facts—Cough and Cold Medicine Abuse (2014). National Institute on Drug Abuse, Maryland, USA. Retrieved from: https://www.drugabuse.gov/publications/drugfacts/cough-cold-medicine-abuse.
[9] Gupta, R. N. (2003). Irrational Combinations and Banned Drugs. Retrieved from: http://www.pharmabiz.com/article/detnews.asp?articleid=17397&sectionid=46).
[10] Solleymani, F., Ahmadizar, F., Meysamie, A., and Abdollahi, M. (2013). A survey on the factors influencing the pattern of medicine's use: Concerns on irrational use of drugs. Journal of Research in Pharmacy Practice, 2(2): 59–63. doi: 10.4103/2279-042X.117385.
[11] Cebotarenco, & Bush. (2007). Antibiotics overuse in children with upper respiratory tract infection in Saudi Arabia: risk factors and potential interventions. Scientific and academic publishing. p-ISSN: 2163-1433. e-ISSN: 2163-1441, 2011; 1(1): 8-16. doi: 10.5923/j.cmd.20110101.02.
[12] Centers for Disease Control and Prevention, USA, 2010 Retrieved from: https://www.cdc.gov/media/pressrel/2010/r100603.htm.
[13] Ibrahim, O. M., and Ayad, M. S. (2012). Antibiotics misuse in different hospital wards (a pilot study in an Egyptian hospital). Asian Journal of Pharmaceutical and Clinical Research, Vol 5, Issue 2.
[14] Prajwala, M., Sresta, K., Supriya, U., and Konuru, V. (2015). A Study on Optimal Duration of Antibiotic Therapy in Various Infectious Diseases. American Journal of Pharmacy and Health Research, 3 (8).
[15] Lin, W., and Zhangc. W. (2004). The Effect of Patient Knowledge and Involvement on Antibiotic Abuse and Health Care Services-Evidence from an Audit Study in China. Article. Retrieved from www.related:cowles.econ.yale.edu/conferences/2010/beijing/lin.pdf
[16] Paluck, E., Katzenstein, D., Frankish, C. J., Herbert, C. P., Milner, R., Speert, D., and Chambers, K. (2001). Prescribing practices and attitudes toward giving children antibiotics. Journal of Can Fam Physician, 47, 521–527.
Author Information
  • Department of Economics, Southeast University, Dhaka, Bangladesh

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    Md. Shahidul Islam. (2017). Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh. International Journal of Health Economics and Policy, 2(4), 152-158. https://doi.org/10.11648/j.hep.20170204.12

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    Md. Shahidul Islam. Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh. Int. J. Health Econ. Policy 2017, 2(4), 152-158. doi: 10.11648/j.hep.20170204.12

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    AMA Style

    Md. Shahidul Islam. Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh. Int J Health Econ Policy. 2017;2(4):152-158. doi: 10.11648/j.hep.20170204.12

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  • @article{10.11648/j.hep.20170204.12,
      author = {Md. Shahidul Islam},
      title = {Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh},
      journal = {International Journal of Health Economics and Policy},
      volume = {2},
      number = {4},
      pages = {152-158},
      doi = {10.11648/j.hep.20170204.12},
      url = {https://doi.org/10.11648/j.hep.20170204.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.hep.20170204.12},
      abstract = {The health sector of Bangladesh registered a significant improvement since the independence of Bangladesh in 1971. Life expectancy at birth which is one of the indicators of economic development increases to 70.65 years in 2014 from 46.88 years in 1972. Nevertheless, misuse of drugs is a common phenomenon in Bangladesh. This study is an attempt to investigate irrational use of drugs, health care level and healthcare expenditure in Bangladesh. The study uses simulated patients and they behaved like ordinary patients when they visited the doctors and collected prescriptions from them. The study finds that there exists a high rate of incorrect diagnosis and inappropriate prescription of drug(s) considering that 82.2% of patients were given more than 2 drugs and 71.2% patients were prescribed antibiotics drug. The rate indeed is very high especially when we consider the fact that the patients were simulated ones with good health. They just pretended being sick. In case of taking physical examination of patients, the situation is worse though the situation at sub-district levels and Dhaka urban area is much better than that in public hospitals. Study finds that cost of drugs per prescription is highest at sub-district level being TK. 301.81 and lowest at Dhaka urban area being TK. 265.20. In public hospital the cost is TK. 232.97 which appears higher than one would expect. All of these impose unnecessary costs on the patients’ healthcare expenditure, increase indebtedness due to income loss, and even employment. Thus, the illness and its related caring expenditures and consequent impacts can severely disrupt living standards. The national policies should emphasize the poverty reduction strategies through improved healthcare status of the country which will ultimately contribute to sustainable development.},
     year = {2017}
    }
    

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    AB  - The health sector of Bangladesh registered a significant improvement since the independence of Bangladesh in 1971. Life expectancy at birth which is one of the indicators of economic development increases to 70.65 years in 2014 from 46.88 years in 1972. Nevertheless, misuse of drugs is a common phenomenon in Bangladesh. This study is an attempt to investigate irrational use of drugs, health care level and healthcare expenditure in Bangladesh. The study uses simulated patients and they behaved like ordinary patients when they visited the doctors and collected prescriptions from them. The study finds that there exists a high rate of incorrect diagnosis and inappropriate prescription of drug(s) considering that 82.2% of patients were given more than 2 drugs and 71.2% patients were prescribed antibiotics drug. The rate indeed is very high especially when we consider the fact that the patients were simulated ones with good health. They just pretended being sick. In case of taking physical examination of patients, the situation is worse though the situation at sub-district levels and Dhaka urban area is much better than that in public hospitals. Study finds that cost of drugs per prescription is highest at sub-district level being TK. 301.81 and lowest at Dhaka urban area being TK. 265.20. In public hospital the cost is TK. 232.97 which appears higher than one would expect. All of these impose unnecessary costs on the patients’ healthcare expenditure, increase indebtedness due to income loss, and even employment. Thus, the illness and its related caring expenditures and consequent impacts can severely disrupt living standards. The national policies should emphasize the poverty reduction strategies through improved healthcare status of the country which will ultimately contribute to sustainable development.
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