Therapeutic budget modelling: a possible road to budgetary allocations in the public health care setting
In South Africa, 70% of the country’s population is dependent on the public health care sector (especially the primary health care structure) for their basic health care needs. The objective of the study is to analyse the cost and usage-related perspectives of medicines, to formulate a therapeutic budget model, for use as a planning and control instrument in the usage of medicines at a public primary care level. Data utilised in this study were obtained from patient records of six local primary health care clinics [N=1 313] in Potchefstroom over a 24-day period. The medicines used by these patients were coded using the proposed medicine classification system.The average cost of medicines per consultation was R8.25 ± 10.98 [N=R19 669.50] for all medicines. The average cost per medicine item was R 4.19 ± 9.54 [N=4 691] for all medicines [N=R19 669.50]. Of the main groups of medicines issued to patients in the clinics, those displaying a total cost of treatment and usage of ≥ 5%, constituted 88.20% and 84.08% of the total medicines used [N=4 691] respectively. From the study it was projected that R2 607 357.00 (231.23% more than the actual budget allocation) is needed for the optimal functioning and management of the six clinics in Potchefstroom. It is foreseen that compiling of a therapeutic budget modelling system would significantly help the public sector to prepare and plan budgetary policies for better medicine formulary and resource management.
Keywords: therapeutic budget model; Cost Prevalence Index (CPI); medicine usage patterns; average medicine cost; public primary health care clinics
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