Private Health Sector Research Articles

Incentive policies for retention of physicians in the private health sector in Portugal

Incentive policies for retention of physicians in the private health sector in Portugal

MT5 Cost-Minimization Analysis to Two Surgical Treatments of Benign Prostatic Hyperplasia in the Brazilian Private Health Sector

Benign prostatic hyperplasia (BPH) can be defined as an enlargement of the prostrate and it is a very prevalent condition affecting almost 90% of the men older than 80 years old. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. Technologies using laser have emerged as an alternative to meet the challenges in treating BPH patients with efficacy and safety superior to the Transurethral Resection of the Prostrate (TURP), the current gold standard. This analysis aims to evaluate the economic impact of Laser Photovaporization of the Prostrate (PVP) in the treatment of BPH within the Brazilian health private sector.

Economic Cost of the Waste of Anti-inflammatory and Analgesic Drugs in Mexico City.

Anti-inflammatory and analgesic medications (AAMs) are widely used in Mexico and the rest of the world. Their excessive acquisition can lead to waste, representing an unnecessary expense for families and the public health system. The aim of this study was to estimate the economic cost of the waste of unused AAMs collected by the National System for the Collection of Residues of Containers and Medications (SINGREM, the acronym in Spanish) in Mexico City during 2019. Data from SINGREM on discarded AAMs in Mexico City were classified by the type and quantity of drug, pharmaceutical dosage form, origin, dose, and the complete or incomplete condition of the package. The unitary cost for each medication was based on public tenders of the Mexican Social Security Institute (IMSS) for the public sector and the prices in large drug store franchises for the private sector. A decision-making model was constructed to appraise the total cost of discarded AAMs. The economic cost of the 48924 units of discarded AAMs in SINGREM containers in Mexico City during 2019 was approx. USD$143500, of which over USD$127000 corresponded to the private health sector. The current findings evidence an enormous accumulation of unneeded or expired AAMs in Mexico City. According to the present data, the cost of such waste is substantial. The estimated cost was 8-fold higher for discarded medications originating from the private versus the public healthcare sector. It is important to implement measures to prevent this waste and increase awareness of the consequences of inadequate drug disposal.

‘Ghost Networks’ Put Patients at Risk of Becoming More Ill

‘Ghost Networks’ Put Patients at Risk of Becoming More Ill

Top 10 public health challenges to track in 2023: Shifting focus beyond a global pandemic

AbstractThe year 2022 saw COVID‐19 as the primary public health concern, with vaccine rollout and mandates at the forefront. Other viral infectious diseases, such as Monkeypox and Ebola, emerged as public health concerns. Climate change and political conflicts significantly impacted global health, increasing the demand for humanitarian assistance and protection. In 2023, it remains crucial to identify global and public health priority areas to coordinate and implement effective solutions. Through discussions with public health practitioners and researchers, we have identified key priority areas for 2023, namely, health systems, the mental health crisis, substance abuse, infectious diseases, malnutrition and food insecurity, sexual and reproductive health challenges, environmental pollution, the climate crisis, cancer, and diabetes. These priority areas highlight shared concerns that should be addressed to facilitate proactive and innovative health interventions and practices. To achieve universal healthcare targets for 2030, prioritization, financial investment, international cooperation, and collaboration in addressing these global health challenges are crucial. This requires coordination among public health decision‐makers, the private health sector, and opinion leaders to implement country‐specific healthcare financing and food security measures. Research, scientific knowledge, and technical capacities must be leveraged to produce sustainable interventions that effectively reduce health disparities and improve health system responsiveness to prevent these challenges from progressing to public health emergencies.

Deciphering the effect of maternal postpartum antibiotic prophylaxis on the infant gut microbiome: a whole metagenomic analysis.

Aim: To analyze the impact of postpartum antibiotic (Ab) prophylaxis on the infant gut microbiome. Materials & methods: Whole metagenomic analysis was performed on breast milk and infant fecal samples collected from mother-infant pairs who belonged to two groups: an Ab group comprising mothers who had received a single course of Abs in the immediate postpartum period and a non-Ab group comprising mothers who had not received Abs. Results: The characteristic presence of Citrobacter werkmanii, an emerging multidrug-resistant uropathogen, and a higher relative abundance of genes encoding resistance to specific Abs were noted in samples from the Ab group compared with those from the non-Ab group. Conclusion: Policies regarding prophylactic Ab prescriptionacross government and private health sectors in the postpartum period need to be strengthened.

‘Good’ and ‘bad’ stem cell research: How India's scientists view providers of unproven stem cell treatments

In this article, I explore the opinions of India's stem cell scientists on unproven and unregulated stem cell treatment provision in the country's private health sector. Drawing on interviews, I describe three themes, namely ethical responsibility; exaggerated timelines for stem cell cures; and the scientific method to demonstrate how scientists make distinctions between themselves as producers of ‘good stem cell research’ and treatment providers who practice ‘bad stem cell research’. Excerpts from my interviews with treatment providers interrupt the discussions in the themes, offering insights on conflicting views of medical professionals. I analyse the themes using the conceptual framework of ‘boundary-work’ that Gieryn developed in order to examine how scientists respond to challenges to their intellectual authority in particular scientific fields. A policy environment that promotes product development posed a threat to the integrity of basic science according to stem cell scientists who simultaneously reflected on solutions to advancing India's stem cell field by promoting the role of clinician-researchers as mediators between medicine and science. According to Gieryn, depending on what is at stake such as funding and public support, scientists redraw boundaries in order to secure their position in relation to competing groups. In this instance, I argue that the expectations of translational research, demanded that scientists examine the boundaries drawn between themselves and clinicians with the purpose of also including the latter in stem cell science rather than for excluding contenders, as Gieryn's notion of boundary-work suggested.

Contracting the private health sector in Thailand's Universal Health Coverage.

Private sector plays an import role in health service provision, therefore the engagement of private health facilities is important for ensuring access to health services. In Thailand, two of the three public health insurance schemes, Universal Coverage Scheme and Social Health Insurance, contract with private health facilities to fill gaps of public providers for the provision of health services under Universal Health Coverage. The National Health Security Office (NHSO) and Social Security Office (SSO), which manage the schemes respectively, have designed their own contractual agreements for private facilities. We aim to understand the current situation of contracting private health facilities within UHC of the two purchasing agencies. This qualitative descriptive case study was conducted through document review and in-depth interviews with key informants to understand how they contract private primary care facilities, service types, duration of contract, standard and quality requirement and renewal and termination of contracts. Private providers make a small contribution to the service provision in Thailand as a whole but they are important actors in Bangkok. The current approaches used by two purchasers are not adequate in engaging private sector to fill the gap of public provision in urban cities. One important reason is that large private hospitals do not find public contracts financially attractive. NHSO classifies contracts into 3 categories: main contracting units, primary care units, and referral units; while SSO only contracts main contracting units. Both allows subcontracting by the main contractors. Contractual agreements are effective in ensuring mandatory infrastructure and quality standards. Both purchasers have established technical capacities to enforce quality monitoring and financial compliance although there remains room for improvement especially on identifying fraud and taking legal actions. Contracting private healthcare facilities can fill the gap of public healthcare facilities, especially in urban settings. Purchasers need to balance the right level of incentives and accountability measures to ensure access to quality of care. In contracting private-for-profit providers, strong regulatory enforcement and auditing capacities are necessary. Further studies may explore various aspects contracting outcomes including access, equity, quality and efficiency impacts.

The benefits and burden of health financing in Indonesia: analyses of nationally representative cross-sectional data

Indonesia has committed to deliver universal health coverage by 2024. Reforming the country's health-financing system is key to achieving this commitment. We aimed to evaluate how the benefits and burden of health financing are distributed across income groups and the extent to which Indonesia has achieved equity in the funding and delivery of health care after financing reforms. We conducted benefit incidence analyses (BIA) and financing incidence analyses (FIA) using cross-sectional nationally representative data from several datasets. Two waves (Feb 1 to April 30, 2018, and Aug 1 to Oct 31, 2019) of the Equity and Health Care Financing in Indonesia (ENHANCE) study household survey involving 7500 households from ten of the 34 provinces in Indonesia were used to obtain health and socioeconomic status data for the BIA. Two waves (2018 and 2019) of the National Socioeconomic Survey (SUSENAS), the most recent wave (2014) of the Indonesian Family Life Survey, and the 2017 and 2018 National Health Accounts were used to obtain data for the FIA. In the BIA, we calculated a concentration index to assess the distribution of health-care benefits (-1·0 [pro-poor] to 1·0 [pro-rich]), considering potential differences in health-care need. In the FIA, we evaluated the equity of health-financing contributions by socioeconomic quintiles by calculating the Kakwani index to assess the relative progressivity of each financing source. Both the BIA and FIA compared results from early 2018 (baseline) with results from late 2019. There were 31 864 participants in the ENHANCE survey in 2018 compared with 31 215 in 2019. Women constituted 50·5% and men constituted 49·5% of the total participants for each year. SUSENAS had 1 131 825 participants in 2018 compared with 1 204 466 in 2019. Women constituted 49·9% of the participants for each year, whereas men constituted 51·1%. The distribution of health-care benefits in the public sector was marginally pro-poor; people with low income received a greater proportion of benefits from health services than people with high income between 2018 (concentration index -0·008, 95% CI -0·075 to 0·059) and 2019 (-0·060, -0·139 to 0·019). The benefit incidence in the private health sector was significantly pro-rich in 2018 (0·134, 0·065 to 0·203, p=0·0010) and 2019 (0·190, -0·192 to 0·572, p=0·0070). Health-financing incidence changed from being moderately progressive in 2018 (Kakwani index 0·034, 95% CI 0·030 to 0·038) to mildly regressive in 2019 (-0·030, -0·034 to -0·025). Although Indonesia has made substantial progress in expanding health-care coverage, a lot remains to be done to improve equity in financing and spending. Improving comprehensiveness of benefits will reduce out-of-pocket spending and allocating more funding to primary care would improve access to health-care services for people with low income. UK Health Systems Research Initiative, UK Department of International Development, UK Economic and Social Research Council, UK Medical Research Council, and Wellcome Trust.

Organization-Set High-Performance Goals and Employee Expediency Syndrome: An Underlying Mechanism of Supervisor Expediency and Illegitimate Tasks

Recent research in organizational behavior reveals that even though expediency is detrimental to an organization, it remains an overlooked phenomenon. Expediency is covert unethical behavior and is challenging to identify because it is mostly confused with proficiency. Limited empirical research can be traced in the literature investigating when and why employee exhibits expediency. This research aims to identify and examine contextual factors in organizations that are the probable cause of employee expediency. Organization-set high-performance goals are examined as a predictor of expediency. Furthermore, supervisor expediency and illegitimate tasks are investigated as mediators to refine the causal mechanism between organization-set high-performance goals and employee expediency. Drawing on the transactional model of stress and coping, it is theorized that organization-set high-performance goals, supervisor expediency, and illegitimate tasks are contextual workplace stressors, and employees exhibit expediency to cope with them. Data is collected from private health sector employees with a sample size of 591. It is a time lag- study with four-wave data collection and two sources, that is, supervisors and subordinates. The results provide empirical support to the hypotheses formulated in the present study. The findings demonstrate that organization-set high-performance goals positively and significantly affect employee and supervisor expediency. Additionally, results confirm the mediation effect of supervisor expediency and illegitimate tasks. Theoretical and practical implications and future research directions are also discussed.

A CROSS-SECTIONAL STUDY TO ASSESS THE PERSPECTIVE OF ALLOPATHIC PRIVATE PROVIDERS FOR THEIR ENGAGEMENT IN TUBERCULOSIS CASE NOTIFICATION UNDER RNTCP

Background: In India 80% of patient first seek private health sector for treatment. This necessitates their engagement in TB eradication programme. Private providers engagement remains a challenging area from decades. Appropriate activities are needed to engage large and unorganized private sector to achieve different milestone in TB case notification and identification. Objective: Study to assess the perspective of allopathic private providers for their engagement in tuberculosis case notification under RNTCP. Methods: Cross-sectional mixed method study among allopathic private providers in Palwal District of Haryana. Conveniently 187 allopathic private providers were approached to assess those factors which can increase their involvement in TB case notification. Private providers were interviewed to check their perspective on mandatory TB case notification Results: This study found that providers are well aware about the RNTCP programme. Overall 59 percent of practitioners favoured the incentives and p-value of 0.014 shows incentive is one factors which can increase their involvement in the programme. Continuing Medical Education (55%) and Notification through hard copy (57%) are preferred ways for engagement. Lack of notification knowledge and complicate process are challenging issues for notification. It was observed stigma, government support and coordination, jurisdiction, and inadequate trainings are remained as barrier from years. Conclusion: There is need to address these issues on priority. Capacity building and educational programmes are required to strengthen the private providers. Simplified notification process and addition of incentives can increase involvement from the private sector. Government support and coordination to private sector are required for achieving the aim of TB Free Ind

Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria-A mixed methods study.

Nigeria has the second largest share of undiagnosed TB cases in the world and a large private health sector estimated to be the point of initial care-seeking for 67% of TB patients. There is evidence that COVID-19 restrictions disrupted private healthcare provision, but insufficient data on how private healthcare provision changed as a result of the pandemic. We conducted qualitative interviews and a survey to assess the impact of the pandemic, and government response on private healthcare provision, and the disruptions providers experienced, particularly for TB services. Using mixed methods, we targeted policymakers, and a network of clinical facilities, laboratories, community pharmacies, and medicine vendors in Kano and Lagos, Nigeria. We interviewed 11 policymakers, surveyed participants in 2,412 private facilities. Most (n = 1,676, 70%) facilities remained open during the initial lockdown period, and most (n = 1,667, 69%) offered TB screening. TB notifications dipped during the lockdown periods but quickly recovered. Clinical facilities reported disruptions in availability of medical supplies, staff, required renovations, patient volume and income. Few private providers (n = 119, 11% in Kano; n = 323, 25% in Lagos) offered any COVID-19 screening up to the time of the survey, as these were only available in designated facilities. These findings aligned with the interviews as policymakers reported a gradual return to pre-COVID services after initial disruptions and diversion of resources to the pandemic response. Our results show that COVID-19 and control measures had a temporary impact on private sector TB care. Although some facilities saw decreases in TB notifications, private facilities continued to provide care for individuals with TB who otherwise might have been unable to seek care in the public sector. Our findings highlight resilience in the private sector as they recovered fairly quickly from pandemic-related disruptions, and the important role private providers can play in supporting TB control efforts.

Medical professionals’ job satisfaction and telemedicine readiness during the COVID-19 pandemic: solutions to improve medical practice in Egypt

BackgroundThe COVID-19 pandemic has impacted medical professionals’ job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice.MethodsData was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice.ResultsThe study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%).ConclusionsDuring the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.

Confidence in the health system and health insurance enrollment among the informal sector population in Lusaka, Zambia

BackgroundTo improve equitable access to quality essential services and reduce financial hardship, low-and-middle-income countries are increasingly relying on prepayment strategies such as health insurance schemes. Among the informal sector population, confidence in the health system to provide effective treatment and trust in institutions can play an important role in health insurance enrollment. The objective of this study was to examine the extent to which confidence and trust affect enrollment into the recently introduced Zambia National Health insurance. MethodsWe conducted a regionally representative cross-sectional household survey in Lusaka, Zambia collecting information on demographics, health expenditure, ratings of last health facility visit, health insurance status and confidence in the health system. We used multivariable logistic regression to assess the association between enrollment and confidence in the private and public health sector as well as trust in the government in general. ResultsOf the 620 respondents interviewed, 70% were enrolled or planning to enroll in the health insurance. Only about one-fifth of respondents were very confident that they would receive effective care in the public health sector ‘if they became sick tomorrow’ while 48% were very confident in the private health sector. While confidence in the public system was only weakly associated with enrollment, confidence in the private health sector was strongly associated with enrollment (Adjusted odds ratio (AOR) 3.40 95% CI 1.73 – 6.68). No association was found between enrollment and trust in government or perceived government performance. ConclusionsOur results suggest that confidence in the health system, particularly in the private health sector, is strongly associated with health insurance enrollment. Focusing on achieving high quality of care across all levels of the health system may be an effective strategy to increase enrollment in health insurance.

Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can...

Healthcare waste management practice and its predictors among health workers in private health facilities in Ilu Aba Bor Zone, Oromia region, South West Ethiopia: a community-based cross-sectional study

ObjectivesA lack of safe healthcare waste management (HCWM) practice poses a risk to healthcare staff, patients and communities. In low-income countries like Ethiopia, studies on the level of safe HCWM...

Assessment of Availability and Quality of Family Planning Services in Private Health Facilities in Plateau State, Nigeria

Worldwide, there are inequitable differences in both the availability and quality of family planning services provided in different geographical regions of the world. In Nigeria's 2018 Demographic Health Survey, only 10.5% of women use a modern contraceptive method with 40.8% of users sourcing them from private sector providers. Despite the complementary role played by the private health facilities, women do not access and use family planning methods adequately. This study assessed the availability and quality of family planning services provided by private health facilities (PHFs) in Plateau state Nigeria. The study was a facility based cross-sectional study of private health facilities across the 17 Local Government Areas of Plateau state. A checklist questionnaire adapted from a combination of similar researches was used to capture details on availability and the quality of family planning services rendered by these private health facilities. Data analysis was done using descriptive and inferential statistics. Three hundred and fifty-six (356) private health facilities were covered in this study, the availability of family planning (FP) in Plateau state PHFs was found to be adequate in 75.3% of the facilities. The quality of family planning services was assessed, majority (59.6%) of the private health facilities has high quality. However, this does not go hand-in-hand with the availability of the same services. Reason for this was due to the differences in location, staff strength, different support given to facilities and the training of staff of the PHFs in the provision of family planning. Only 59% of these facilities were able to score above 13.5 on quality score and thereby considered as having high quality. There is need for more private health facilities inclusion in all forms of manpower development in family planning by government and other partners; this is to help improve the quality of family planning services in the private health sector of the state and country at large.

COVID-19 Vaccine Service Delivery Challenges: A Rapid Assessment of Private Health Facilities Providing COVID-19 Vaccination in Maharashtra, India, 2021

International Journal of Medicine and Public Health,2022,12,4,169-174.DOI:10.5530/ijmedph.2022.4.31Published:January 2023Type:Original ArticleCOVID-19 Vaccine Service Delivery Challenges: A Rapid Assessment of Private Health Facilities Providing COVID-19 Vaccination in Maharashtra, India, 2021Aikant Bhatti, Purva Raj, Rishabh Chopra, Ravdeep Gandhi, Jessica Mooney, Farzana Muhib, and Manoj Mehta Aikant Bhatti1, Purva Raj2,*, Rishabh Chopra3, Ravdeep Gandhi4, Jessica Mooney5, Farzana Muhib6, Manoj Mehta7 1Senior Monitoring, Evaluation and Learning Officer, PATH, India Country Program, 15th floor, Gopal Das Bhawan, Barakhamba Road, New Delhi, INDIA. 2Monitoring, Evaluation and Learning associate, PATH, India Country Program, 15th floor, Gopal Das Bhawan, Barakhamba Road, New Delhi, INDIA. 3Lead, Strategy and Communications, South Asia Region, PATH, India Country Program, 15th floor, Gopal Das Bhawan, Barakhamba Road, New Delhi, INDIA. 4Deputy Director, Marketing and Operations, PATH, India Country Program, 15th floor, Gopal Das Bhawan, Barakhamba Road, New Delhi, INDIA. 5Program Officer, CVIA Policy, Access, and Introduction Functional Area, PATH, Seattle Headquaters, 2201 Westlake Ave Suite 200, Seattle, WA 98121, UNITED STATES OF AMERICA. 6Senior Program Officer, CVIA Policy, Access, and Introduction Functional Area, Washington DC Headquarters, UNITED STATES OF AMERICA 7Data Manager, PATH, India Country Program, 15th floor, Gopal Das Bhawan, Barakhamba Road, New Delhi, INDIA. Abstract:Background: The private health sector has a significant role in the delivery of health services in India. However, given fast changing COVID-19 pandemic, it is critical to understand the role of the private health sector in delivery of services going forward. The supply of COVID-19 vaccines is firmly regulated by the Government of India and the private sector received unrestricted access to vaccine supply directly from manufacturers from June 2021 onwards. Materials and Methods: PATH carried out a rapid assessment of private health facilities in the state of Maharashtra to understand the challenges faced by private facilities in providing COVID-19 vaccination. Results: During the assessment it was found that 100% of the private health facilities have a robust cold chain system which is essential for safe storage of COVID-19 vaccines and delivery of immunization services. The in-charges of the health facilities reported difficulty in estimating requirement of COVID-19 vaccines doses, as 67% of the beneficiaries in Mumbai and Nashik were direct walk-ins. During the assessment 93.3% of the facilities were observed to have adequate availability of COVID-19 vaccines doses, based on the beneficiary registration data for the day. Ministry of Health, Government of India, recommends a trained 5-member vaccination team for providing services at each vaccination site. Conclusion: The key challenges faced by private health facilities during delivery of COVID-19 immunization were associated with differential vaccine pricing, time taken to receive supply of vaccines, difficulties in accurately estimating vaccine demand, multiple record keeping at the facility level and declining vaccine demand. Keywords:COVID–19 pandemic, Private health sector., Service delivery, VaccinationView:PDF (142.3 KB)

Effectiveness of private medical organizations in the Russian healthcare system

The article is devoted to the development of the private sector of medical services in our country in order to improve the health of the population, which is the main task of healthcare in general. Private clinics have advantages over public institutions: no queues, courtesy of staff, increased comfort, etc. Despite the progressive development of private medicine, there are certain problems that cannot be solved without an integrated approach to healthcare in general. The object of the study is commercial medical organizations; the subject of the study is the efficiency (profitability) of the activities of commercial medical organizations. The methodological basis of this study is comparative analysis, empirical and systematic approaches. The author pays special attention to the problems of interaction between the public and private segments in the field of medical services provided to the population. As a result of the conducted research, it was concluded that the solution of the identified problems is facilitated by the optimization of interaction between the public and private health sectors, including the optimization of financial flows of mandatory, voluntary health insurance funds and direct payments of patients. The novelty of the study lies in determining the main criterion for the effective optimization of the interaction between the public and private health sectors – the economic accessibility of paid medical services to the population. The approaches indicated in the article will not only increase the opportunities of the population in the field of healthcare, but also improve the quality of medical services in both private and public spheres.

Prescription patterns of analgesics for oral conditions in india - Analysis of large medical audit data of outpatients in India's private healthcare sector.

Analgesic use needs to be regulated due to its adverse effects. This study aimed to analyse the change in prescription rates and patterns of the analgesics prescribed for various oral conditions and to analyse their trends across different age groups and gender to promote rational prescription of drugs and eventually influence regulatory policies. Secondary analysis was conducted on medical audit data collected from the private health sector in India. The prescription rate per 1000 persons per year was calculated from May 2013 to April 2016 using the mean projected population (PP) of India. Cross-tabulations were conducted to analyse the prescription rate and their changes across different age groups, gender and oral conditions. The mean analgesic prescription rate was highest among the 20-40 age group, and the highest increase was noted in 'non-steroidal anti-inflammatory drug (NSAID) combinations' (3.56 per 1000 persons per year) from May 2013 to April 2016. The 'NSAID combinations' group was also the most prescribed medication across all the oral conditions, with 'diseases of hard tissues' having the highest prescription rate (41.4 and 45.6 per 1000 persons per year, respectively, for 2013-14 and 2015-16). The results indicate an overall increase in the analgesic prescription rate, especially 'NSAID combinations' for each dental disease and age group, a finding that is hard to explain. Due to the lack of prescription guidelines in India, it is difficult to assess whether these analgesics were prescribed rationally or not.