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Trends and Appropriateness of Outpatient Prescription Drug Use in Veterans
Korean J Clin Pharm 2018;28(2):107-116
Published online June 30, 2018
© 2018 Korean College of Clinical Pharmacy.

Iyn-Hyang Lee* and Da-Young Shim

College of pharmacy, Yeungnam University, Gyeongsan 38541, Republic of Korea
Correspondence to: * Iyn-Hyang Lee, College of pharmacy, Yeungnam University, 280 Daehak-ro, Gyeongsan-si, Gyeongsan 38541, Republic of Korea
Tel: +82-53-810-2829, Fax: +82-53-810-4654 E-mail: leeiynhyang@ynu.ac.kr
Received March 18, 2018; Revised June 12, 2018; Accepted June 12, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords : Veterans, drug utilization, drug costs, therapeutic duplication


June 2018, 28 (2)
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