Korean J Clin Pharm.  2018 Jun;28(2):107-116. 10.24304/kjcp.2018.28.2.107.

Trends and Appropriateness of Outpatient Prescription Drug Use in Veterans

Affiliations
  • 1College of pharmacy, Yeungnam University, Gyeongsan 38541, Republic of Korea. leeiynhyang@ynu.ac.kr

Abstract


OBJECTIVE
This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting.
METHODS
The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models.
RESULTS
In equivalent conditions, veteran patients made fewer visits to medical institutions (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 drug costs than MAID patients (p < 0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p < 0.0001).
CONCLUSION
Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.

Keyword

Veterans; drug utilization; drug costs; therapeutic duplication

MeSH Terms

Drug Costs
Drug Utilization
Humans
Insurance, Health
Logistic Models
National Health Programs
Outpatients*
Prescriptions*
Veterans*
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