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Basic & Clinical Pharmacology & Toxicology
Article . 2018 . Peer-reviewed
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A review of the Ghana National Health Insurance Scheme claims database: possibilities and limits for drug utilization research

possibilities and limits for drug utilization research
Authors: Ankrah, Daniel; Hallas, Jesper; Odei, James; Asenso-Boadi, Francis; Dsane-Selby, Lydia; Donneyong, Macarius;

A review of the Ghana National Health Insurance Scheme claims database: possibilities and limits for drug utilization research

Abstract

AbstractBackgroundThere are inadequate data on prescribed drug utilization in Sub‐Saharan Africa (SSA). Drug utilization research (DUR) in this region is hampered by lack of access to databases that capture prescribed drug utilization such as health insurance claims, electronic medical records and disease registries. The primary objective of this MiniReview was to describe the content of the NHIS claims database in the context of the health care system in Ghana. We will also review the possibilities and limitations of analysing this novel database for drug utilization research (DUR) in Ghana.MethodsWe reviewed the history, composition of the database, coverage and health systems in Ghana. To demonstrate the application of the NHIS claims database for DUR, we reviewed the NHIS’ drug formulary (NHIS medicines’ list), assessed and quantified the utilization of the top 25 most commonly prescribed medicines and their distributions by age, sex, region of residence and by MDCs.ResultsAs of December 2014, about 40% (~10.5 million) of the Ghanaian population were active beneficiaries of NHIS. There were 1.43 million unique patients in the NHIS claims database who received services from about 81 providers located in 9 out of the 10 regions in Ghana. The mean age of this sample of beneficiaries was 31 (standard deviation, 22) years, a third of whom were aged <18 years old. Nearly, 2 out of every 3 beneficiaries were females. On average, there were approximately 3 outpatient visits per beneficiary in 2015. There were about 522 unique drugs on the NHIS medicine list. Overall, analgesic was the most prescribed class of medicine (mostly paracetamol and diclofenac). Antimalarials, artemether‐lumefantrine, were observed as the second most prescribed medicines followed by anti‐infectives (metronidazole) and antihypertensives (amlodipine).ConclusionThe Ghana NHIS claims database is a great resource for DUR. This database could also be extended to facilitate pharmacoepidemiological and other health services’ research especially if transformed into one of the existing standardized common data models.

Keywords

Drug Prescriptions/statistics & numerical data, Databases, Factual, National Health Programs, national health insurance scheme, claims database, drug utilization research, Databases, Factual/statistics & numerical data, Drug Prescriptions, Ghana, Databases, Insurance Claim Review, Drug Utilization Review, Drug Utilization Review/methods, Insurance Claim Review/statistics & numerical data, Factual/statistics & numerical data, Humans, defined daily dose, National Health Programs/statistics & numerical data

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
17
Top 10%
Top 10%
Average
Green
bronze