The Journal of Hospital Accreditation (JHA)
Vol. 6 No. 1 (2024)

Assessment Of Drug Use And Provider Compliance In Outpatient Care

Rita Prameswari (Hospital Management, Graduate Program in Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.)
Rina Kurniasri Kusumaratna (Department of Public Health, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia)
Erna Kristin (Department of Pharmacology and Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia)



Article Info

Publish Date
29 Jul 2026

Abstract

Background: Outpatient services represent a major source of hospital revenue and require efficient resource management. At AN-NISA Hospital, the neurology and psychiatry outpatient clinics showed the largest negative gap between INA-CBGs tariffs and hospital costs. Drug expenditures accounted for approximately 95% of the total INA-CBGs tariffs. Objective: To evaluate drug use indicators and provider compliance and to determine their association with drug use costs in neurology and psychiatry outpatient clinics. Methods: This observational analytic study employed a cross-sectional design with total sampling. A total of 769 prescriptions from National Health Insurance (JKN) outpatients with the two most common diagnoses and the highest drug use costs during October 2021 were analyzed. Drug use indicators were evaluated using WHO and National Formulary standards. Simple linear regression assessed the relationship between each independent variable and drug use costs, while multiple linear regression identified the strongest predictors. Results: Prescribing practices in both clinics did not meet WHO standards regarding adherence to the National Formulary, compliance with Referral Program (PRB) prescribing restrictions, the average number of drugs prescribed per prescription, and provider compliance. Generic prescribing met WHO standards only in the psychiatry clinic. Drug utilization costs in the psychiatry clinic were significantly associated with National Formulary prescribing (R=0.774), PRB prescribing (R=−0.092), generic prescribing (R=−0.611), the average number of drug items per prescription (R=0.221), and provider compliance (R=−0.478) (all p<0.05). In the neurology clinic, significant associations were found for National Formulary prescribing (R=0.682), PRB prescribing (R0.073), generic prescribing (R=−0.323), and provider compliance (R=−0.225), whereas the number of drug items prescribed showed no significant association (R=0.009; p>0.05). Generic prescribing was the strongest predictor of drug utilization costs in both neurology (β=−0.235) and psychiatry (β=−0.499). Conclusion: Drug use indicators and provider compliance in the neurology and psychiatry outpatient clinics have not fully met established standards and were significantly associated with drug use costs. Increasing generic prescribing may improve prescribing efficiency and reduce medication costs. Multidisciplinary collaboration among hospital management, pharmacists, information technology personnel, and clinicians is essential to promote rational prescribing and optimize healthcare costs.

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Journal Info

Abbrev

JHA

Publisher

Subject

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

Description

Jurnal ini diperuntukan untuk sosialisasi artikel ilmiah terkait dengan pengembangan, penerapan dan evaluasi sistem akreditasi rumah sakit, termasuk didalamnya artikel ilmiah tentang regulasi akreditasi, standar akreditasi, manajemen lembaga akreditasi, surveior akreditasi, dan berbagai hal lain ...