보건행정학회지 (Health Policy and Management)

  • 제27권3호
  • /
  • Pages.247-255
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  • 2017
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  • 1225-4266(pISSN)
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  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
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Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee (Department of Health Policy and Management, Yonsei University Graduate School of Public Health) ;
  • Han, Kyu-Tae (Research and Analysis Team, National Health Insurance Service Ilsan Hospital) ;
  • Park, Sohee (Department of Biostatistics, Yonsei University Graduate School of Public Health) ;
  • Moon, Ki Tae (National Evidence-Based Healthcare Collaborating Agency) ;
  • Park, Eun-Cheol (Institute of Health Services Research, Yonsei University College of Medicine)
  • 투고 : 2017.09.08
  • 심사 : 2017.09.15
  • 발행 : 2017.09.30
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초록

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

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