OUTPATIENT DRUG EXPENDITURES AND PRESCRIPTION POLICIES FOR DISEASES WITH HIGH COST TO THE NATIONAL HEALTH INSURANCE SYSTEM IN TAIWAN
Resource
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION v.103 n.4 pp.280-285
Journal
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
Journal Volume
v.103
Journal Issue
n.4
Pages
280-285
Date Issued
2004
Date
2004
Author(s)
LANG, HUI-CHU
LAI, MEI-SHU
CHEN, GAU-TZU
Abstract
Background and Purpose: The high cost of drugs, particularly those used to treat upper respiratory tract infections, is an increasingly important problem for the National Health Insurance system in Taiwan. This study proposed a new classification scheme for reimbursing drug cost and estimated its impact on expenditures and health care utilization. Methods: Data were obtained from the National Health Research Institutes' year 2000 computer file of the National Health Insurance Academic Research Database in Taiwan. Two factors, were used to classify medications: 1) urgency of medications required; and 2) patient's self- care ability. Results: Among the 10 diseases with the highest number of outpatient department (OPD) visits, 7 were upper respiratory diseases. Acute upper respiratory infections ( URIs) and acute nasopharyngitis were the 2 diseases with the highest number of OPD visits. Drug expenditure for acute URIs is about 6% of total expenditure for drugs. Medications suitable for URIs patients' self-care accounted for 42.8% of the total cost of prescribed drugs for these illnesses, and treatment medications unsuitable for patients' self-care accounted for 48.6%. Other medications used for URIs could not be grouped into these categories. The total expenditure for acute nasopharyngitis was about 1.3% of total expenditure for drugs. Medications suitable for self-care,in patients with nasopharyngitis accounted for 51.8% of the total cost of medication prescribed for this illness, and medications,unsuitable for patients' self-care accounted for 36.8%. Conclusions: Reducing the medications suitable for patients' self-care, and enforcing different levels of payment rates, on medication's unsuitable for patients' self -care may reduce the excessive use of OPD drugs, improve the appropriateness of utilization for acute UZIs and the common cold and allow medical resources to be distributed more efficiently.
Subjects
economics
pharmaceutical
health expenditure
health insurance
respiratory tract infections
Type
journal article
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