Aspekte van medisynevoorsiening aan distriksgeneeshere en -aptekers

Abstract

It has been alleged that the distribution and consumption of medicine by the government medical services is unsatisfactory. One complaint is that wastage of state medicine occurs. To counter these claims the government has made several changes to the way in which medicine is dispensed to certain patients in South Africa. One way of distributing medicine to state patients is through the services of district surgeons and district pharmacies. This method of distribution has drawn the hospital pharmacist into the public sector. It has also given a whole new dimension to the hospital pharmaceutical business. On 3 April 1989 the Executive Director of Hospital Services gave permission to the Kalie de Haas Hospital in Potchefstroom to provide prepacked medicine to eighteen district surgeons in the Western Transvaal. The medicine is stored and distributed under strict control to those patients who are in the care of the Transvaal Provincial Administration. On 10 April 1990 this service was supplemented when provision was made for the district pharmacist to dispense prepacked state medicine to patients of the district surgeon. The general purpose of the study was to investigate scientifically the dispensing of medicine to district surgeons and district pharmacies by the pharmacy of the Kalie de Haas Hospital during the period from September 1990 to December 1991. Special attention was given to the following aspects: - The expiry date on stock during this period. - The identification of problems in the ordering of stock by the district clinics. - Problems of control that might be experienced by the district pharmacists. - An analysis of costs according to the consumption pattern. During the period from September 1990 to December 1991 a survey was made of the expiry date on medicines at eighteen district clinics in the Western Transvaal. Attention was paid to the cost of the medicine required, the expiry date of the medicine, the various disease conditions and the way in which each clinic ordered medicine. Inspections were conducted on a rotational basis to determine the nature and extent of pharmaceutical services provided by the district clinics. The investigation exposed the existence of a direct link between the demand for medicine required for a specific illness and the expiry date on that medicine. It has also been determined that the current measures employed by the district clinics when ordering stock are inadequate and do not eliminate wastage. The results indicate that a large proportion of the hospital pharmacist's time is devoted to logistical tasks and the packing of stock while relatively little time is spent on medicine control at clinic level. It can be conducted from this investigation that alternative methods of control over all aspects of the dispensing of medicine should be implemented. An altered control structure based on the actual costs of medicine dispensed per patient, as indicated by his/her prescription, is recommended. It is anticipated that the proposed control measures will bring about a saving on the cost of medicine for hospital authorities.