7.2.1 Total outpatients seen - Consultation, dispensary waiting times and dispensing times for facilities which saw more than 20,000 outpatients in 1996 (n = 5), were not significantly different from those facilities which saw less than 20,000 outpatients in 1996 (n = 9). (These factors had not been previously examined in any study known to the authors). While average dispensary waiting time was higher in those facilities with an outpatient load of more than 20,000, it was not significantly different from those facilities that saw fewer patients.
7.2.2. Total number of personnel - The total number of prescribers and dispensers did not correlate with consulting, waiting or dispensing times. Nor did the number of dispensers correlate with adequate labelling.
7.2.3 Average number of drugs per prescription - There was no significant relationship between a facility's average dispensary waiting time and the facility's average number of drugs per prescription.
7.2.4 Prescriber education, experience, supervision and training - Prescriber education, experience, training and supervision did not correlate with consulting times or patient knowledge of drug regimen.
7.2.5 Dispenser experience - There was no relationship between the mean number of years worked at the CBC or the mean number of years dispensing and the time a patient spent waiting at the dispensary for a drug prescription to be filled. Neither was there a relationship between dispenser experience and time spent dispensing the drugs, or how well a patient knew drug name, regimen, purpose and side-effects.
7.2.6 Dispenser education - There was no significant relationship between dispensary waiting time and dispensers' non-health-related formal education. However, facilities where at least two-thirds of the dispensers had secondary schooling (n = 5) spent significantly longer time dispensing drugs than those facilities where less than two-thirds of the dispensers had secondary education (n = 9). Mean dispensing time for those facilities where at least two-thirds of dispensers had secondary schooling was 1.57 minutes, compared to 0.98 minutes for those facilities where less than two-thirds of the dispensers had secondary schooling. This difference of 0.59 minutes was significant at p =.021. Unfortunately, this did not translate to greater patient knowledge, as there was no significant relationship between dispenser education and training, time spent dispensing drugs and patient knowledge.
7.2.7 Dispensing-specific training - There was a slightly positive relationship between dispensers who had taken a dispensing-specific training and dispensing times. However this relationship was not significant. There was no relationship between dispensing training and dispensary waiting time and patient knowledge.
7.2.8 Dispenser supervision - Those facilities which reported receiving off-site CBC supervision (n = 5) had a significantly lower average dispensary waiting time than those facilities which did not report receiving off-site supervision (n = 9). Average dispensary waiting time in facilities that receive off-site supervision was 10.86 minutes, compared to 20.04 minutes average waiting time in facilities without off-site supervision. The difference of 9.18 minutes was significant at p =.04. Results are summarized in Table 8.
Table 8. Correlation of patient care indicators and independent variables
Patient care indicators |
|
Magnitude (min) |
Difference |
p - value |
Average consulting time with patient |
Total weeks dispensary training |
not significant |
|
|
| |
Total outpatients seen |
not significant |
|
|
| |
Total number of screeners |
not significant |
|
|
Average dispensary waiting |
Off-site supervision |
10.9-20.0 |
9.18 min |
p =.04 |
time for patient |
Total weeks dispensary training |
not significant |
|
|
| |
Total outpatients seen |
not significant |
|
|
| |
Total number of dispensers |
not significant |
|
|
Average dispensing time per patient |
Total weeks dispensary training |
not significant |
|
|
| |
Total outpatients seen |
not significant |
|
|
| |
Total number of dispensers |
not significant |
|
|
| |
+ 66% personnel with secondary school |
.98-1.57 min |
0.59 min |
p =.021 |
Patient knowledge |
Total weeks dispensary training |
not significant |
|
|
| |
Average dispensing time |
not significant |
|
|
In summary, there was a positive relationship between a lower average number of drugs per prescription, prescribers' age, experience, education and training, on-site supervision, and frequency of doctor's visits. There were fewer significant relationships between antibiotic prescription rates and the independent variables examined. Only prescriber training and frequency of doctor's visits correlated with a lower antibiotic prescription rate. There were no significant correlations between average cost per prescription and any of the independent variables examined. Neither did the number of outpatients seen correlate with any of the drug indicators examined.
There was a positive relationship between shorter dispensary waiting times and longer dispensing times with off-site supervision and dispenser education, respectively. There were no significant correlations between average consulting times, patient knowledge and percent of drug packages adequately labelled and any of the independent variables examined. Finally, the number of outpatients seen did not correlate with average consultation times, dispensary waiting times or dispensing times.
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