Corporation Stock Register by sgw19866

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									Using Longitudinal Data for
Evaluating Policy Changes and
Other Interventions


-Information system in Tamilnadu
Medical Services Corporation
   MURALI.R, SATHYANARAYANAN.D,
RAJKUMAR.C, SENTHIL KUMAR.R & TITUS.U
 INSTITUTE OF COMMUNITY MEDICINE,
  MADRAS MEDICAL COLLEGE, CHENNAI
INTRODUCTION
 An efficient health care delivery
  system is an important requisite to
  achieve health for all.

 Access to essential drugs is probably
  the most important element of health
  care delivery system.
The Government of Tamil Nadu, India
      realizing this, developed and
implemented various strategies under
  the broad framework of Tamil Nadu
    Medical Services Corporation to
control and monitor drug procurement,
 storage and distribution to the Public
     sector hospitals in the state.
Monitoring and
  evaluation
H.O.Server   CT Scan    Drug Management &
             System     Monitoring System
                                      Warehouse
                                      Information
                                      System

                                              QC
M.I.S.
                                              Monitoring
                                              System


 Financial                                    Payroll &
 Accounts                                     Personal

                                     Construction
                                     Management
Automated
Material
Handling               Supplier Information
Data collection at the
facility level:
 Pass book of TNMSC

 Stock registers

 Sub-stock register

 Daily token register

 Doctor’s diagnosis register
PATIENT FLOW
Stock status at a central
warehouse
                                                                                                                           Desired months of stock
                                                               STOCK STATUS BY MONTH                                       Minimum - 10 Maximum - 21
                                                                    AMOXYCILLIN

                  100


                  80
STOCK IN MONTHS




                  60


                  40


                  20


                   0
                        Jan-97




                                          Jul-97

                                                   Oct-97

                                                            Jan-98



                                                                              Jul-98

                                                                                       Oct-98

                                                                                                Jan-99




                                                                                                                  Jul-99
                                                                     Apr-98




                                                                                                                           Oct-99

                                                                                                                                    Jan-00



                                                                                                                                                      Jul-00
                                 Apr-97




                                                                                                         Apr-99




                                                                                                                                             Apr-00



                                                                                                                                                               Oct-00
                  -20
                                                                                          MONTHS
                        Drugs Indented for 3 years
                                 in a PHC
              70

              60

              50
No.of Drugs




              40

              30

              20

              10

              0
                       1996-1997                         1997-1998                         1998-1999

                   Total no. of drugs indented                       No. of drugs indented from the PHC list
                   No.of drugs indented outside the PHC list         No. of drugs not indented from the PHC list
Impact of Tamil Nadu Medical Services
Corporation on Drug Prescribing in primary
health care- an example
1)To study the impact of the TNMSC in
  primary care centres (PHCs) on a)
  availability of 15 core essential drugs; b)
  continuous availability of an adequate
  quantity of the core essential drugs; and
  c) rational use of drugs in PHCs;
2) to study the maintenance of quality of
  drugs by the TNMSC and
3) to study the control of drug
  expenditures by the TNMSC.
Study design

 Longitudinal time series with control
  before and after various TNMSC
  interventions (20 PHCs Vs 20
  Controls).

 Time series study of government rural
  PHCs before and after various
  TNMSC interventions in 1994-8.
Feasible indicators
   % of key drugs available
   average number of days of stock-out.
   % cases receiving prescription;
   average number of drugs per prescription;
    % drugs prescribed by generic name;
    % drugs prescribed that belong to the PHC EDL
    (51 drugs);
   % prescriptions containing an antibiotic;
   % prescriptions containing a vitamin
    % prescriptions containing an injection;
   average cost per prescription.
   % of prescriptions as per STG
 10 years of data is to be preserved
  at every point of time

 This gives sufficient longitudinal
  data to evaluate the policy change.
Limitations

 Missing data ( the tokens of a year
  or a portion of the year may be
  missing)
 Non-uniformity in writing the
  diagnosis
 Injection tokens often not well
  preserved
Thank you

								
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