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Expenditures on High-cost Drugs and the Difference in Their Use under Various Health Insurance Schemes in a Regional Hospital in North-Eastern Thailand

หน่วยงาน สถาบันวิจัยระบบสาธารณสุข

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ชื่อเรื่อง : Expenditures on High-cost Drugs and the Difference in Their Use under Various Health Insurance Schemes in a Regional Hospital in North-Eastern Thailand , รายจ่ายของยาที่มีค่าใช้จ่ายสูงและความแตกต่างของการใช้ยาเหล่านั้นในระบบประกันสุขภาพประเภทต่างๆ ภายในโรงพยาบาลศูนย์แห่งหนึ่งในภาคตะวันออกเฉียงเหนือ, ประเทศไทย
นักวิจัย : Yupapun Munkratok , Vithaya Kulsomboon , Yupadee Sirisinsuk
คำค้น : high cost drug , health insurance , expenditure , ยาที่มีค่าใช้จ่ายสูง , ระบบประกันสุขภาพ , รายจ่าย
หน่วยงาน : สถาบันวิจัยระบบสาธารณสุข
ผู้ร่วมงาน : ยุภาพรรณ มันกระโทก , วิทยา กุลสมบูรณ์ , ยุพดี สิริสินสุข , Maharat Nakhon Ratchasima Hospital , Chulalongkorn University. Faculty of Pharmaceutical Sciences , Chulalongkorn University. Faculty of Pharmaceutical Sciences
ปีพิมพ์ : 2552
อ้างอิง : วารสารวิจัยระบบสาธารณสุข 3,2(เม.ย.-มิ.ย.2552) : 242-251 , 0858-9437 , http://hdl.handle.net/11228/2759
ที่มา : -
ความเชี่ยวชาญ : -
ความสัมพันธ์ : -
ขอบเขตของเนื้อหา : ไทย
บทคัดย่อ/คำอธิบาย :

Background: Essential drugs in Subclass 4 are high-cost drugs (HCDs). Their use was an important factor in influencing pharmaceutical expenditure. Exploring drug items, extent of their use, and the difference in their use among health insurance schemes would provide in-depth understanding of the efficiency and equity of their use. The objectives of this study were to identify items of HCDs, to assess their impact on pharmaceutical expenditure, and to explore HCD users classified by age and type of health insurance schemes. Methods: Retrospective data on overall drug expenditure including the top 10 HCDs in Subclass 4 of the Essential Drug List in three fiscal year (2003-2005) were obtained from the Hospital Inventory Database. Drug use data of the to 10 HCDs in 2005 were obtained from the Dispensing Database. The rates of the top 10 HCD use per 1,000 patients were classified by age and health insurance scheme, including the Universal Coverage Scheme (UC), Civil Servants Medical Benefit Scheme (CSMBS), and Social Security Scheme (SSS), and compared. Results: In the three consecutive years, the six HCDs most highly used were human erythropoietin 4000 u. inj., atorvastatin 10 mg tab., meropenem 1g inj, imipenem/cilastatin 500 mg/vial IV, cefoperazone/salbactam 1g inj and clopidogrel 75 mg tab. The top 10 HCDs used in the hospital consumed 45.6 million, 50.5 million, and 68.8 million baht in 2003, 2004 and 2005 respectively. Expenditures on erythropoetin 4000 u., atorvastatin 10 mg., clopidogrel 75 mg and meropenem inj. 1g increased every year. In 2005, 63.8 percent or 46.8 million baht of the expenditure of the top 10 HCDs was on CSMBS. These items were the drugs used for chronic diseases: erythropoietin, atorvastatin, clopidogrel. and mycophenolate. HCD spending in UC was 32.3 percent or 23.6 million baht, but it was only 1 percent in SSS. In UC, the drug items mainly used were anti-infectious drugs, including meropenem, imipenem/cilastatin and cefoperazone/salbactam. The rate of use of atorvastatin and clopidogrel per 1,000 patients in the aging group in CSMBS were 20.08 and 6.47 respectively. In UC, they were only 0.05 and 1.45 respectively. The rate of use of meropenem per 1,000 patients in every age group in UC was greater than in CSMBS. Discussion: The impact of HCD use on pharmaceutical expenditure is quite high since only 10 HCDs account for 18-20 percent of overall pharmaceutical expenditure. There is a difference in HCD use based on the insurance schemes. Further studies should be focused on the evaluation of HCD use, effective measures to control HCD use, and methods to balance equity of HCD access among health insurance schemes.

สถาบันวิจัยระบบสาธารณสุข

บรรณานุกรม :
Yupapun Munkratok , Vithaya Kulsomboon , Yupadee Sirisinsuk . (2552). Expenditures on High-cost Drugs and the Difference in Their Use under Various Health Insurance Schemes in a Regional Hospital in North-Eastern Thailand.
    นนทบุรี : สถาบันวิจัยระบบสาธารณสุข.
Yupapun Munkratok , Vithaya Kulsomboon , Yupadee Sirisinsuk . 2552. "Expenditures on High-cost Drugs and the Difference in Their Use under Various Health Insurance Schemes in a Regional Hospital in North-Eastern Thailand".
    นนทบุรี : สถาบันวิจัยระบบสาธารณสุข.
Yupapun Munkratok , Vithaya Kulsomboon , Yupadee Sirisinsuk . "Expenditures on High-cost Drugs and the Difference in Their Use under Various Health Insurance Schemes in a Regional Hospital in North-Eastern Thailand."
    นนทบุรี : สถาบันวิจัยระบบสาธารณสุข, 2552. Print.
Yupapun Munkratok , Vithaya Kulsomboon , Yupadee Sirisinsuk . Expenditures on High-cost Drugs and the Difference in Their Use under Various Health Insurance Schemes in a Regional Hospital in North-Eastern Thailand. นนทบุรี : สถาบันวิจัยระบบสาธารณสุข; 2552.