보훈의료지원 대상자의 외래 처방의약품 사용경향과 적정성 평가
Trends and Appropriateness of Outpatient Prescription Drug Use in Veterans
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Objective: This study analyzed the national claims data of veterans to generate scientific evidence of the trends andappropriateness of their drug utilization in an outpatient setting. Methods: The claims data were provided by the Health InsuranceReview & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. NationalHealth Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groupsby using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed byusing multivariate logistic regression models. Results: In equivalent conditions, veteran patients made fewer visits to medicalinstitutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p<0.05); similarly,veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drugcosts than MAID patients (p<0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than inNHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p<0.0001). Conclusion: Similar patterns of drug use were foundin veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longerprescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if anyinefficiency exists in veterans’ drug use behavior.
Abstract
Objective: This study analyzed the national claims data of veterans to generate scientific evidence of the trends andappropriateness of their drug utilization in an outpatient setting. Methods: The claims data were provided by the Health InsuranceReview & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. NationalHealth Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groupsby using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed byusing multivariate logistic regression models. Results: In equivalent conditions, veteran patients made fewer visits to medicalinstitutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p<0.05); similarly,veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drugcosts than MAID patients (p<0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than inNHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p<0.0001). Conclusion: Similar patterns of drug use were foundin veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longerprescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if anyinefficiency exists in veterans’ drug use behavior.
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