A case study about the implementation of the regulation on prescription for health insurance out-patients in a general hospital in Vietnam, 2022

Objectives: Prescribing is an activity that plays a crucial role in ensuring safe and rational drug use. However, inappropriate prescription practices are still common worldwide, including in Vietnam. This study aimed to analyze the prescriptions of outpatients with health insurance cards at Cam Ranh General Hospital, Khanh Hoa Province in 2022. Methods: The study design was a cross-sectional study incorporating both quantitative and qualitative research methods. The study involved 400 outpatient prescriptions with Health Insurance cards in 2022, combined with in-depth interviews with hospital leaders, heads of the Medical Examination Department, the Pharmacy Department, health insurance supervisors, and group discussions with seven physicians working in the Medical Examination Department. Results: The research findings showed that the hospital had a good compliance rate of 100% regarding administrative procedures in prescription writing. Prescription omission of instructions for follow-up visits, dietary regimens, and rest constituted 27.7% of cases. Outpatient prescriptions containing antibiotics accounted for 23.3%, while those containing vitamin tablets accounted for 9.3%. The misuse rate of Vinpocetine tablets was 30%, and Ginkgo biloba tablets accounted for 25%. The average number of drugs per prescription was 3.1. Prescriptions with drug interactions accounted for 3.5%. Rejected health insurance payment claims for prescriptions accounted for 3.5%. Conclusion: To enhance the safety and rationality of prescription writing, the hospital should implement software that alerts drug interactions and monitors the appropriate use of medications Keywords: Prescription, outpatient prescriptions, Health Insurance, outpatient care, drug use,