A review of the Ghana National Health Insurance Scheme claims database

possibilities and limits for drug utilization research

Daniel Ankrah, Jesper Hallas, James Odei, Francis Asenso-Boadi, Lydia Dsane-Selby, Macarius Donneyong*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

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Resumé

BACKGROUND: There 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.

METHODS: We 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.

RESULTS: As 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).

CONCLUSION: The 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.

OriginalsprogEngelsk
TidsskriftBasic & Clinical Pharmacology & Toxicology
Vol/bind124
Udgave nummer1
Sider (fra-til)18-27
ISSN1742-7835
DOI
StatusUdgivet - jan. 2019

Fingeraftryk

Health insurance
Drug Utilization
Ghana
National Health Programs
Databases
Research
Pharmaceutical Preparations
Medicine
Health
Electronic medical equipment
Formularies
Amlodipine
Africa South of the Sahara
Electronic Health Records
Diclofenac
Health Services Research
Age Distribution
Metronidazole
Antimalarials
Acetaminophen

Citer dette

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. I: Basic & Clinical Pharmacology & Toxicology. 2019 ; Bind 124, Nr. 1. s. 18-27.
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title = "A review of the Ghana National Health Insurance Scheme claims database: possibilities and limits for drug utilization research",
abstract = "BACKGROUND: There 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.METHODS: We 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.RESULTS: As 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).CONCLUSION: The 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.",
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author = "Daniel Ankrah and Jesper Hallas and James Odei and Francis Asenso-Boadi and Lydia Dsane-Selby and Macarius Donneyong",
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A review of the Ghana National Health Insurance Scheme claims database : possibilities and limits for drug utilization research. / Ankrah, Daniel; Hallas, Jesper; Odei, James; Asenso-Boadi, Francis; Dsane-Selby, Lydia; Donneyong, Macarius.

I: Basic & Clinical Pharmacology & Toxicology, Bind 124, Nr. 1, 01.2019, s. 18-27.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

TY - JOUR

T1 - A review of the Ghana National Health Insurance Scheme claims database

T2 - possibilities and limits for drug utilization research

AU - Ankrah, Daniel

AU - Hallas, Jesper

AU - Odei, James

AU - Asenso-Boadi, Francis

AU - Dsane-Selby, Lydia

AU - Donneyong, Macarius

PY - 2019/1

Y1 - 2019/1

N2 - BACKGROUND: There 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.METHODS: We 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.RESULTS: As 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).CONCLUSION: The 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.

AB - BACKGROUND: There 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.METHODS: We 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.RESULTS: As 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).CONCLUSION: The 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.

KW - claims database

KW - defined daily dose

KW - drug utilization research

KW - Ghana

KW - national health insurance scheme

KW - Databases, Factual/statistics & numerical data

KW - Insurance Claim Review/statistics & numerical data

KW - Drug Prescriptions/statistics & numerical data

KW - National Health Programs/statistics & numerical data

KW - Humans

KW - Drug Utilization Review/methods

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DO - 10.1111/bcpt.13136

M3 - Review

VL - 124

SP - 18

EP - 27

JO - Basic & Clinical Pharmacology & Toxicology

JF - Basic & Clinical Pharmacology & Toxicology

SN - 1742-7835

IS - 1

ER -