Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh

Abstract

The health sector of Bangladesh registered a significant improvement since the independence of Bangladesh in 1971. Life expectancy at birth which is one of the indicators of economic development increases to 70.65 years in 2014 from 46.88 years in 1972. Nevertheless, misuse of drugs is a common phenomenon in Bangladesh. This study is an attempt to investigate irrational use of drugs, health care level and healthcare expenditure in Bangladesh. The study uses simulated patients and they behaved like ordinary patients when they visited the doctors and collected prescriptions from them. The study finds that there exists a high rate of incorrect diagnosis and inappropriate prescription of drug(s) considering that 82.2% of patients were given more than 2 drugs and 71.2% patients were prescribed antibiotics drug. The rate indeed is very high especially when we consider the fact that the patients were simulated ones with good health. They just pretended being sick. In case of taking physical examination of patients, the situation is worse though the situation at sub-district levels and Dhaka urban area is much better than that in public hospitals. Study finds that cost of drugs per prescription is highest at sub-district level being TK. 301.81 and lowest at Dhaka urban area being TK. 265.20. In public hospital the cost is TK. 232.97 which appears higher than one would expect. All of these impose unnecessary costs on the patients’ healthcare expenditure, increase indebtedness due to income loss, and even employment. Thus, the illness and its related caring expenditures and consequent impacts can severely disrupt living standards. The national policies should emphasize the poverty reduction strategies through improved healthcare status of the country which will ultimately contribute to sustainable development.