مطالعه پیمایشی وضعیت سیستم دارویی داروخانههای شهر شیراز از دیدگاه مراجعهکنندگان
محورهای موضوعی : -مدارک پزشکیپیوند باستانی 1 , حسام درستی 2 , مهدیه سادات احمد زاده 3
1 - استادیار، مرکز تحقیقات مدیریت سلامت و منابع انسانی، دانشکده مدیریت و اطلاع رسانی پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران
2 - دانشجوی دکتری بیوتکنولوژی دارویی، دانشکده علوم و فنون نوین، دانشگاه علوم پزشکی شیراز، شیراز، ایران
3 - کارشناسارشد مدیریت بهداشت و درمان، دانشکده مدیریت و اطلاع رسانی پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران
کلید واژه: پرداخت از جیب, داروخانه, زمان انتظار, سیستم دارویی,
چکیده مقاله :
مقدمه: داروخانهها از جمله مراکز خدماتی ضروری و حیاتی میباشندکه مراجعه مردم و بیماران به آنها اهمیت زیادی دارد. در ایران، بخش عظیمیاز منابع بهداشتی و درمانی به منظور تهیه و تدارک داروهای مورد نیاز جامعه مصرف میشود. این مطالعه به بررسی دیدگاه مراجعان به داروخانههای شیراز در مورد سیستم دارویی داروخانهها میپردازد. روش پژوهش: این مطالعه به صورت پیمایش مقطعی، در سال1395 انجام شد. جامعه پژوهش مراجعهکنندگان به داروخانههای سطح شهر، داروخانههای دولتی، داروخانه هلال احمر و داروخانه ویژه بود. با استفاده از فرمول کوکران حجم نمونه 150 نفر در نظرگرفته شد. ابزار گردآوری دادهها فرم محقق ساخته بود که پایایی آن با استفاده از ضریب همبستگی88/0 و روایی آن ازطریق تایید متخصصان برآورد گردید. تجزیه وتحلیل دادهها با استفاده از نرمافزار SPSS22 و آزمونهای کروسکال والیس وفیشر انجام شد. یافتهها: بر اساس آزمون کروسکال والیس بین رضایت ازداروخانهها و نوع داروخانه (p=0.046)، بین نوع داروخانه و مدت زمان انتظار بیمار (p<0.001) و بین نوع بیماری و میزان پرداخت از جیب بیماران (p<0.001) رابطه معناداری وجودداشت. همچنین بین میزان مشاوره دارویی توسط داروساز و نوع داروخانه و نوع بیمه و میزان پرداخت از جیب رابطه معنادار مشاهده نشد. (p>0.05) نتیجهگیری: بنظر میرسد با استفاده از نتایج حاضر، مسئولان دانشگاه میبایست با سیاستگذاری صحیح در جهت کاهش هزینه پرداخت از جیب بیماران گام بردارند. همچنین توجه به آموزشهای عمومیدر زمینه نحوه صحیح مصرف دارو و نیز توجه به برنامههای بازاریابی اجتماعی در راستای ارتقای سطح سواد سلامت و رضایت جامعه نسبت به داروخانهها ضروری میباشد.
Introduction: Pharmacies are considered as the necessary centers for public and patients. In Iran, a great deal of health sector resources is consumed for procurement of medicines. This survey is conducted to investigate pharmaceutical system of Shiraz pharmacies from the clients` view points. Methods: This was a cross sectional survey that was conducted in 2016. The study population includes those who refer to community pharmacies, governmental and special pharmacies. The study sample was considered 150 according toCochranformula. A researcher made form was applied for data collection which its reliability was estimated 0.88 applying Pearson Correlation and the validity was approved through experts` views. SPSS22 was used for data analysis was applying Kruskal–Wallis one-way analysis of variance and Fisher`s exact test. Results: According to Kruskal–Wallis a significant relationship was considered between patient satisfaction and pharmacy type(p=0.046), pharmacy type and waiting time(p<0.001) and type of illness and out of pocket(p<0.001) but there was no significant relationship between the rate of pharmaceutical consult and pharmacy type or the insurance type and out of pocket payment(p>0.05). Conclusion: It seems that considering the present results, the university superiors must try to decrease out of pocket payment on medicines through correct policy making. At the same time, accordance with general educations about drug use and social marketing for improving health literacy they should try to increase satisfaction toward the pharmacies.
1- Tavakooli R. Effect of important variables; economic, social and cultural on self-medication. Medical Daneshvar, 2001; 8(34): 9-12. [In Percian]
2- Stephens M. Hospital Pharmacy. United Kingdom: Pharmaceutical Press; 2003: 65-9.
3- Farsam H. The pathology of pharmacy etichs. Iran J Med Ethics Hist Med, 2008; 1(1): 61-6.
4- How to develop and implement a national drug policy. Geneva: World Health Organization; Second edition ed: WHO; 2001.
5- Bastani P, Ahmadi Marzale M, Dehghani M, Falahzdeh M, Rahmati E, Tahernejad A. The status of Iranian hospital pharmacies according to age‑friendly pharmacies criteria. J Adv Pharm Technol Res, 2017; 8: 120-4.
6- Bastani P, Mehralian G, Dinarvand R. Resource allocation and purchasing arrangements to improve accessibility of medicines: Evidence from Iran. J Res Pharm Pract, 2015; 4: 9-17.
7- Bastani P, Dinarvand R, SamadBeik M, Pourmohammadi K. Pharmaceutical strategic purchasing requirements inIran: Price interventions and the related effective factors. J Res Pharm Pract, 2016; 5: 35-42.
8- Nunes de Melo M, Madureira B, Nunes Ferreia A, Mendes Z, Miranda AdC, Martins A. Prevalence of self-medication in rural areas of Portugal. Pharm World Sci, 2006; 28(1): 19-25.
9- Maldonado J, Meléndez S, Figueras A. Longterm effects of an educational intervention on self-medication and appropriate drug use in single-sex secondary public schools, Quito, Ecuador. Br J Clin Pharmacol, 2007; 63(1): 92-9.
10- Doustar Sanaei M, Sobhani A. Pattern of drug consumption and its changes during the first trimester of pregnancy. J Qazvin Univ Med Sci, 2002; 20(1): 55-61. [In Percian]
11- Shou Y. Perspectives on Supply Chain Management in the Healthcare Industry. 2nd International Conferenceon Science and Social Research: Atlantis Press; 2013.
12- Ahmadi B, Mohammadian M, Mahmoodi M. Pattern of medication in people 55 years and older residing in Tehran. Iranian J Ageingو 2007; 2(6): 421-6. [In Percian]
13- Davati A, Jafari F, Samadpoor M, Tabar K. Survey of medication in ageing of Tehran city. J Med Council Islamic Republic Iran, 2008; 25(4): 450-6.
14- Awan M, Raouf A, Ahmad N, Sparks L. Total quality management in developing countries A case of pharmaceutical wholesale distribution in Pakistan. International Journal of Pharmaceutical and Healthcare Marketing, 2009; 3(4): 363-80.
15- Barati O, Dorosti H, Talebzadeh A, Bastani P. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university. J Adv Pharm Technol Res, 2016; 7: 70-4.
16- Bastani P, Jooybar M, Ahmadzadeh M, Samadbeik M. Community pharmacy-based survey on pharmacists’ knowledge, attitude, and performance regarding dietary supplements: Evidence from South of Iran. Natl J Physiol Pharm Pharmacol, 2017; 7(4): 396-402.
17- Mehralian G, Bastani P. Pharmaceutical strategic purchasing:A key to improve access to medicines. Iran J Pharm Res, 2015; 14: 345-6.
18- Sarkhanlou F, Saeedi M, Janbabai Gh, Nikfar Sh, Semnani K, Zaboli P. Comparative Study of Direct Patient and Drug Costs before and after the Implication of Healthcare Reform Program in Sari, Iran. J Mazandaran Univ Med Sci, 2016; 26(142): 228-232.
19- Mortazavi SA, Hajebi G. Study the problems Related to the Handling and Delivery of Pharmaceutical Services in Hospital Pharmacy Coverage Martyr Beheshti University of Medical Sciences; Journal of Medical, 2002; 26(3): 205-15. [In Percian]
20- Yazdani Charati J, Nikpour A, Nazar I. Patients’ Satisfaction Level from Services Provided in Sari Tooba Clinic and Associated Factors Using Hotelling's. J Mazandaran Univ Med Sci, 2015; 25(132): 210-218.
21- Ebadi A, Mohamadian M. Comparison of the satisfaction of patients admitted to hospital discharge and two weeks later Najmieh (research project). Tehran, Health
_||_1- Tavakooli R. Effect of important variables; economic, social and cultural on self-medication. Medical Daneshvar, 2001; 8(34): 9-12. [In Percian]
2- Stephens M. Hospital Pharmacy. United Kingdom: Pharmaceutical Press; 2003: 65-9.
3- Farsam H. The pathology of pharmacy etichs. Iran J Med Ethics Hist Med, 2008; 1(1): 61-6.
4- How to develop and implement a national drug policy. Geneva: World Health Organization; Second edition ed: WHO; 2001.
5- Bastani P, Ahmadi Marzale M, Dehghani M, Falahzdeh M, Rahmati E, Tahernejad A. The status of Iranian hospital pharmacies according to age‑friendly pharmacies criteria. J Adv Pharm Technol Res, 2017; 8: 120-4.
6- Bastani P, Mehralian G, Dinarvand R. Resource allocation and purchasing arrangements to improve accessibility of medicines: Evidence from Iran. J Res Pharm Pract, 2015; 4: 9-17.
7- Bastani P, Dinarvand R, SamadBeik M, Pourmohammadi K. Pharmaceutical strategic purchasing requirements inIran: Price interventions and the related effective factors. J Res Pharm Pract, 2016; 5: 35-42.
8- Nunes de Melo M, Madureira B, Nunes Ferreia A, Mendes Z, Miranda AdC, Martins A. Prevalence of self-medication in rural areas of Portugal. Pharm World Sci, 2006; 28(1): 19-25.
9- Maldonado J, Meléndez S, Figueras A. Longterm effects of an educational intervention on self-medication and appropriate drug use in single-sex secondary public schools, Quito, Ecuador. Br J Clin Pharmacol, 2007; 63(1): 92-9.
10- Doustar Sanaei M, Sobhani A. Pattern of drug consumption and its changes during the first trimester of pregnancy. J Qazvin Univ Med Sci, 2002; 20(1): 55-61. [In Percian]
11- Shou Y. Perspectives on Supply Chain Management in the Healthcare Industry. 2nd International Conferenceon Science and Social Research: Atlantis Press; 2013.
12- Ahmadi B, Mohammadian M, Mahmoodi M. Pattern of medication in people 55 years and older residing in Tehran. Iranian J Ageingو 2007; 2(6): 421-6. [In Percian]
13- Davati A, Jafari F, Samadpoor M, Tabar K. Survey of medication in ageing of Tehran city. J Med Council Islamic Republic Iran, 2008; 25(4): 450-6.
14- Awan M, Raouf A, Ahmad N, Sparks L. Total quality management in developing countries A case of pharmaceutical wholesale distribution in Pakistan. International Journal of Pharmaceutical and Healthcare Marketing, 2009; 3(4): 363-80.
15- Barati O, Dorosti H, Talebzadeh A, Bastani P. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university. J Adv Pharm Technol Res, 2016; 7: 70-4.
16- Bastani P, Jooybar M, Ahmadzadeh M, Samadbeik M. Community pharmacy-based survey on pharmacists’ knowledge, attitude, and performance regarding dietary supplements: Evidence from South of Iran. Natl J Physiol Pharm Pharmacol, 2017; 7(4): 396-402.
17- Mehralian G, Bastani P. Pharmaceutical strategic purchasing:A key to improve access to medicines. Iran J Pharm Res, 2015; 14: 345-6.
18- Sarkhanlou F, Saeedi M, Janbabai Gh, Nikfar Sh, Semnani K, Zaboli P. Comparative Study of Direct Patient and Drug Costs before and after the Implication of Healthcare Reform Program in Sari, Iran. J Mazandaran Univ Med Sci, 2016; 26(142): 228-232.
19- Mortazavi SA, Hajebi G. Study the problems Related to the Handling and Delivery of Pharmaceutical Services in Hospital Pharmacy Coverage Martyr Beheshti University of Medical Sciences; Journal of Medical, 2002; 26(3): 205-15. [In Percian]
20- Yazdani Charati J, Nikpour A, Nazar I. Patients’ Satisfaction Level from Services Provided in Sari Tooba Clinic and Associated Factors Using Hotelling's. J Mazandaran Univ Med Sci, 2015; 25(132): 210-218.
21- Ebadi A, Mohamadian M. Comparison of the satisfaction of patients admitted to hospital discharge and two weeks later Najmieh (research project). Tehran, Health