Provider responses to a global budgeting system: The case of drug expenditures in Taiwan hospitals

2020 ◽  
Vol 29 (10) ◽  
pp. 1270-1278
Author(s):  
Shin‐Yi Chou ◽  
James A. Dearden ◽  
Mary E. Deily ◽  
Hsien‐Ming Lien
Keyword(s):  
Drug Expenditures ◽  
Global Budgeting

Drug Utilization Studies – An Overview

2010 ◽  
Vol 3 (1) ◽  
pp. 803-810 ◽  
Author(s):  
Shalini S ◽  
Ravichandran V ◽  
Saraswathi R ◽  
BK Mohanty ◽  
Dhanaraj S K
Keyword(s):  
Drug Utilization ◽  
Evidence Based ◽  
Future Trends ◽  
Medical Prescription ◽  
Drug Usage ◽  
Current State ◽  
Patterns Of Use ◽  
Drug Utilization Studies ◽  
Drug Expenditures

 Aspire of the Drug Utilization Studies (DUS) is to appraise factors related to the prescribing, dispensing, administering and taking of medication, and it’s associated. Since the middle of twentieth century, interest in DUS has been escalating, first for market-only purposes, then for appraising the quality of medical prescription and comparing patterns of use of specific drugs. The scope of DUS is to evaluate the current state and future trends of drug usage, to estimate roughly disease pervasiveness, drug expenditures, aptness of prescriptions and adherence to evidence-based recommendations. The increasing magnitude of DUS as a valuable investigation resource in pharmacoepidemiology has been bridging it with other health allied areas, such as public health, rational use of drug, evidence based drug use, pharmacovigilance, pharmacoeconomics, eco-pharmacovigilance and pharmacogenetics.

Quality Assessment of Ethics in Health Care: The Accountability Revolution

1994 ◽  
Vol 20 (1-2) ◽  
pp. 105-128
Author(s):  
Susan M. Wolf
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Quality Assessment ◽  
Central Place ◽  
World War ◽  
New Era ◽  
The Third ◽  
Cost Cutting ◽  
Global Budgeting

Writing in 1988, Arnold Relman heralded the dawning of the “third revolution“ in medical care. The first revolution, at the end of World War II, had inaugurated an Era of Expansion, with an explosion of hospitals, physicians, and research. Medicare and Medicaid were passed, and medicine experienced a golden age of growth. Inevitably, according to Relman, this yielded to an Era of Cost Containment starting in the 1970s. The federal government and private employers revolted against soaring costs, brandishing the weapons of prospective payment, managed care, and global budgeting. Yet these blunt instruments of cost-cutting eventually produced concern over how to evaluate the quality of health care, to promote the good while trimming the bad. Thus Relman announced the arrival of the Era of Assessment and Accountability.This chronology helps explain the current importance of quality. Quality assessment and more recently, quality improvement techniques, occupy a central place in this new era.

Evaluation of chemotherapy preparation processes: Volumetric method reliability and gravimetric method utility within 5 US hospitals

2021 ◽  
Author(s):  
Adam Moss ◽  
Stephanie Kang ◽  
Kathryn Morbitzer ◽  
Lam Nguyen ◽  
Moe Shwin ◽  
...  
Keyword(s):  
Gravimetric Method ◽  
The United States ◽  
Volumetric Method ◽  
Preparation Process ◽  
Accuracy And Precision ◽  
Data Collection Process ◽  
Accurate Dose ◽  
Actual Volume ◽  
Drug Expenditures ◽  
Transfer Device

Abstract Disclaimer In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The primary aim of this study was to investigate the accuracy of the volumetric method for intravenous (IV) preparations and explore the utility of gravimetric methods in the medication preparation process within multiple institutions. Secondary outcomes of this study were syringe size percent variations and impact on drug expenditures. Methods A prospective, noninterventional, multisite study was conducted between March 2015 and December 2016 to generate baseline estimates of accuracy and precision in the volumetric medication preparation process. Five hospitals in the United States were recruited for study participation. During the data collection process, technicians were required to measure the syringe at 3 different points: when the new empty syringe was connected to a closed-system transfer device (CSTD), when the filled syringe containing the prepared dose of medication was connected to a CSTD, and when the used syringe with residual medication was connected to a CSTD. The actual dose of drug dispensed (in mg) was divided by the specific gravity of the medication to determine the actual volume of medication dispensed. Results A total of 4,443 compounded sterile products representing 60 medications across 5 hospitals were eligible for the study. Of the evaluated preparations, 91.92% were within 5% of the prescribed dose and 96.56% were within 10% of the prescribed dose. The outliers ranged from –144.10% to 233.72%. Conclusion The potential for significant over- and undertreatment of an individual patient receiving IV chemotherapy exists, indicating the need for an additional measurement method, such as real-time gravimetric verification, to ensure an accurate dose is administered to every patient.

Ambulatory Care: Medication Use Characteristics in an Ambulatory Elderly Population in Taiwan

1997 ◽  
Vol 31 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Rou-Yee Chen Hsu ◽  
Min-Shung Lin ◽  
Mei-Huei Chou ◽  
Ming-Fang Lin
Keyword(s):  
Hormone Replacement ◽  
The Elderly ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Prescribing Patterns ◽  
Cross Sectional Survey ◽  
Antiinflammatory Drugs ◽  
Cross Sectional ◽  
Therapeutic Category ◽  
Prescribing Trends ◽  
Drug Expenditures

Objective To compare prescribing patterns between the elderly and nonelderly in 1994, to disclose prescribing trends in the elderly between 1992 and 1994, to explore whether drug utilization is in agreement with disease prevalence, and to identify suboptimal prescribing by drug category for ambulatory elderly patients. Design Cross-sectional survey at two separate time intervals. Setting All public group practice centers (GPCs) in Taiwan. Patients Ambulatory adults who visited GPCs during 1 random week. Those 65 years or over were classified as the elderly group, and those 20-64 years were the nonelderly group. Main Outcome Measures Mean diagnosis, drug use, and expenditure; frequency of diagnosis; and prescribing by therapeutic category. Results Data on 30 777 elderly and 38 184 nonelderly patients were collected in 1994. There was widespread use of antacids. Compared with nonelderly adults, the elderly were diagnosed with more diseases (1.3 vs. 1.2, respectively; p < 0.01), received more medications (4.7 vs. 4.1, respectively; p < 0.01), and had higher drug expenditures (5.4 vs. 4.6, respectively; p < 0.01). Chronic illness was more prevalent in the elderly, which accounted for the extensive use of cardiovascular drugs (32.1%), nonsteroidal antiinflammatory drugs (25.9%), and anxiolytics (15.9%). The upward trend in the elderly from 1992 to 1994 with hypertension (18.6% vs. 20.0%) or diabetes (9.2% vs. 10.9%) did not result in more cases of cerebrovascular disease (7.1% vs. 4.9%). There was a substantial increase in use of antispasmodic and gastroprokinetic agents (4.5% to 10.7%); the use of antacids decreased (73.6% to 63.4%) in the elderly. Conclusions Compared with the prevalence of disease, there was extensive nonspecific use of anxiolytics and antacids. However, lessened use of antidepressants and postmenopausal hormone replacement may have an impact on morbidity and mortality and deserves particular attention.

Projecting future drug expenditures—2000

2000 ◽  
Vol 57 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Bernard Mehl ◽  
John P. Santell
Keyword(s):  
Future Drug ◽  
Drug Expenditures

scholarly journals Factors Contributing to Increases in Prescription Drug Expenditures Borne by National Health Insurance in South Korea

2016 ◽  
Vol 57 (4) ◽  
pp. 1016 ◽  
Author(s):  
Jeong-Sook Jo ◽  
Young-Man Kim ◽  
Kyung Won Paek ◽  
Min Hee Bea ◽  
Kihong Chun ◽  
...  
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Prescription Drug ◽  
National Health Insurance ◽  
National Health ◽  
Drug Expenditures

The Medicare Part D Coverage Gap, Prescription Use, and Expenditures

2018 ◽  
Vol 77 (5) ◽  
pp. 442-450 ◽  
Author(s):  
Aig Unuigbe
Keyword(s):  
Affordable Care Act ◽  
Financial Risk ◽  
Medicare Part D ◽  
Medicare Part ◽  
General Increase ◽  
Part D ◽  
Coverage Gap ◽  
Heterogeneous Effects ◽  
Drug Expenditures ◽  
Donut Hole

The Affordable Care Act has put in place policies to gradually close the Medicare Part D coverage gap (donut hole). I examine the effect of this gradual closure on total and out-of-pocket prescription drug expenditures, as well as the number of prescriptions filled. The analysis shows a general increase in prescription use. There are also heterogeneous effects, with higher total expenditure groups seeing a decrease in their out-of-pocket prescription expenditures. This suggests that closure of the “donut hole” has led to an increase in prescription use that was previously curtailed and had an impact on the financial risk faced by Medicare recipients. This has implications for trends in prescription use and Medicare expenditures in the future, as the coverage gap is closed further.

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