Understanding medication oversupply and its predictors in the outpatient departments in Thailand

BMC Health Services Research

Todd A Lee⁴  Katechan Jampachaisri³  Napawan Jeanpeerapong⁵  Piyarat Nimpitakpong²  Nathorn Chaiyakunapruk¹  Piyameth Dilokthornsakul² 

[1] School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA;Department of Pharmacy Practice, Center of Pharmaceutical Outcomes Research, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand;Department of Mathematics, Faculty of Sciences, Naresuan University, Phitsanulok, Thailand;Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA;Department of Pharmacy, Buddhachinaraj Hospital, Muang, Phitsanulok, Thailand

关键词: Thailand;    Factors association;    Financial loss;    Prevalence;    Medication oversupply;   

Others  :  1126353
DOI  :  10.1186/1472-6963-14-408

 received in 2013-10-09, accepted in 2014-09-15,  发布年份 2014

【 摘 要 】

Background

Medication oversupply is an important problem in the healthcare systems. It causes unnecessary avoidable healthcare costs. Although some studies have determined the magnitude and financial loss due to medication oversupply in western countries, they may not be applicable to Asia-pacific countries. This study aims to determine the prevalence, financial loss, and patterns of medication oversupply and the factors associated with such oversupply in Thailand.

Methods

A retrospective database analysis was used from 3 public hospitals. Patients visiting the outpatient department of the hospitals in 2010 and receiving at least 2 prescriptions within 6 months were included. The modified medication possession ratio (MPRm) was used to determine the medication supply. Patients having MPRm > 1.20 were defined as receiving a medication oversupply. The measures were prevalence of medication oversupply, the number of oversupplied medications, and financial loss (2012 dollars) due to medication oversupply. Hierarchical logistic regression was used to determine the factors associated with the prevalence of medication oversupply.

Results

A total of 99,743 patients were included. Patients were on average 49.7 ± 21.2 years of age, and 42.8% were male. Most of them were adult (53.7%). Among those patients, 60.2% of the patients were under universal coverage schemes. Around 13.4% of all the patients received a medication oversupply, and the patients in regional hospitals had a higher prevalence of medication oversupply than patients in district hospitals (13.8% VS 8.2%). The patients under civil servant medical benefit schemes (CSMBS) (13.6%) had the most prevalence of medication oversupply. The total financial loss was $189,024 per year. The average financial loss was $1.9 ± 19.0 per patient/year. Patients under CSMBS experienced the highest average financial loss (2.6 ± 23.2 $/patient/year). Age, gender, health insurance schemes, and the number of medications that the patients received were the factors associated with medication oversupply.

Conclusions

Medication oversupply is an important problem for the health system. Patients receiving care from regional hospitals had a higher likelihood of medication oversupply. Policymakers may consider developing policies for preventing medication oversupply. The policy should be implemented in regional hospitals and especially in children or patients with poly-pharmacy.

【 授权许可】

   
2014 Dilokthornsakul et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 3.

Figure 2.

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