scholarly journals The Influence of National Health Insurance on Medication Adherence Among Outpatient Type 2 Diabetics in Southwest Nigeria

2017 ◽  
Vol 5 (2) ◽  
pp. 114-119
Author(s):  
Saka S Ajibola ◽  
Fajemirokun O Timothy
Keyword(s):  
Health Insurance ◽  
Medication Adherence ◽  
National Health Insurance ◽  
Drug Cost ◽  
National Health ◽  
Diabetic Patients ◽  
Uninsured Patients ◽  
Type 2 Diabetics ◽  
Southwest Nigeria

Purpose: Medication adherence (MA) is a challenge among patients with chronic diseases worldwide. Little has been reported on the influence of National Health Insurance Scheme (NHIS) on MA among diabetic patients in Nigeria. Objective: To assess the influence of NHIS on MA among outpatient type 2 diabetics in 2 public secondary health facilities in Southwest Nigeria. Method: A cross-sectional study involving 110 consecutively selected outpatient type 2 diabetics (insured, n = 42; uninsured, n = 68) was carried out. The patients’ perceptions of care and the influence of drug cost on MA between the insured and uninsured were compared. The patients’ perceptions of care were assessed using a 25-item pretested questionnaire. The MA was measured using the Morisky MA-8 scale. The use of oral antidiabetic drugs (OADs) was evaluated using a medical chart review. Information about patients’ sociodemographics, year of diagnosis, comorbidities, and types of OADs prescribed was retrieved from the medical records. Descriptive statistics were used for data presentation. A Pearson χ2 was used for test of associations. P values < .05 were considered significant. Results: Majority of the respondents (68 [61.8%]) were uninsured. The insured and the uninsured patients differed in their perceptions of the adequacy of time used by pharmacists for medication counseling ( P < .0005). The MA between the groups also differs ( P = .0002). The monthly drug cost for OADs was significantly associated with MA ( P = .037). Conclusion: The study concluded that the NHIS may positively influence MA among diabetic patients. The drug cost may have contributed significantly to the difference in MA between the groups. More time should be devoted to the counseling of the uninsured patients.

Association Between the Diabetes Drug Cost and Cardiovascular Events for Type 2 Diabetes in Korea: A National Health Insurance Service Database Analysis

2021 ◽  
Author(s):  
Seung Min Chung ◽  
Ji-In Lee ◽  
Eugene Han ◽  
Hyun-Ae Seo ◽  
Eonju Jeon ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Insurance ◽  
National Health Insurance ◽  
Drug Cost ◽  
National Health ◽  
Protective Factor ◽  
Coronary Revascularization ◽  
Long Term Effects ◽  
Diabetes Drug

Abstract Background: We aimed to investigate the long-term effects of diabetes drug costs on cardiovascular (CV) events and death. Methods: This retrospective observational study used the 2009–2018 National Health Insurance data in Korea. Among patients with type 2 diabetes, those who were taking antidiabetic drugs and did not have CV events before 2009 were included. Data on the annual cost of each diabetes drug were collected. The 10-year incidence of CV events (cardiac death, non-fatal myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization) and CV death were analyzed according to the diabetes drug cost quartiles (Q1 [the lowest] – Q4 [the highest]).Results: A total of 441,914 participants were enrolled (median age, 60 years; male, 57%). CV events and death occurred in 28.1% and 8.36% of patients, respectively. The overall diabetes drug cost was USD 271/year per person (range: 1–18,921). The 10-year incidence of CV events and death was lowest in Q3 and high in Q4 and Q1. After adjusting for CV risk factors, the risk of CV events increased in the sequential order of cost quartiles (hazard ratio (HR)=1 [ref], 1.102 [95% confidence interval (CI): 1.084–1.120], 1.137 [95% CI: 1.118–1.156], and 1.323 [95% CI: 1.3011.346]). The risk of CV death showed U-shaped pattern which was lowest in the Q3 (HR=0.943, 95% CI 0.903-0.984) and highest in the Q4 (HR= 1.234, 95% CI 1.182-1.287).Conclusion: The expenditure for diabetes drug affects 10-year CV events and death. Affording an appropriate diabetes cost at a similar CV risk is an independent protective factor for CV death.Trial registration: retrospectively registered

scholarly journals DRUG COST ANALYSIS ON NATIONAL HEALTH INSURANCE ERA IN HEALTH SUPPORT FACILITIES

2017 ◽  
Vol 10 (2) ◽  
pp. 119
Author(s):  
Satibi Satibi ◽  
Dewa Ayu Putu Satrya Dewi ◽  
Atika Dalili Akhmad ◽  
Novita Kaswindiarti ◽  
Dyah Ayu Puspandari
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
Drug Cost ◽  
National Health ◽  
Health Facilities ◽  
Drug Costs ◽  
Average Percentage ◽  
Primary Health

Objective: In national health insurance (JKN) era, pharmacy can play roles in the form of behind refer pharmacies, or networking pharmacy and clinic pharmacy pratama. Behind refer pharmacies drug cost can be claimed directly to BPJS, meanwhile for the other type of pharmacy have to negotiation first with the primary health care. Drug cost variations in the JKN era affect the profitability of the business pharmacies. This research aims to the drug percentage charges against capitation and variety of drug costs.Methods: This research is analytic observational cross-sectional. This research uses secondary data from a JKN prescription patient. This research was conducted on 6 affiliated pharmacies, 6 networking pharmacies, and 7 clinical pharmacy pratama in DIY. The sampling in this research is by purposive with 8.430 prescriptions. Data drug costs JKN era was analyzed by descriptive statistics and comparative test (Kruskal Wallis test).Results: The result showed that average percentage of drug costs for capitation fee in the networking pharmacy is 13.58% and primary health care is 15.91%. Pharmacy in JKN era has drug cost variations (p=0.000). Drug cost in JKN era depends on the pattern of play roles with the health facilities and BPJS. The average percentage of drug costs against capitation health facilities in networking pharmacy is lower than clinical pharmacy pratama.Conclusions: Drug costs in an era of JKN depending on the pattern of cooperation with health facilities pharmacies and BPJS. The average percentage of the cost of drugs to the pharmacy capitation health facilities in networking lower than clinic pharmacy pratama. Differences in drug costs JKN era influenced by the long days of drug administration, the number of prescription sheets, margin.Keywords: Drug cost analysis, National health insurance (JKN), Pharmacy, Primary health care, Capitation.

Medical expenditure for diabetic patients: A 10-year follow-up study of National Health Insurance in Shiga, Japan

Public Health ◽  
2008 ◽  
Vol 122 (11) ◽  
pp. 1226-1228 ◽  
Author(s):  
K. Nakamura ◽  
T. Okamura ◽  
H. Kanda ◽  
T. Hayakawa ◽  
Y. Murakami ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Medical Expenditure ◽  
Diabetic Patients ◽  
Follow Up Study

scholarly journals Fenofibrate Use Is Associated With Lower Mortality and Fewer Cardiovascular Events in Patients With Diabetes: Results of 10,114 Patients From the Korean National Health Insurance Service Cohort

2021 ◽  
Author(s):  
Sang-Ho Jo ◽  
Hyewon Nam ◽  
Jeongwoo Lee ◽  
Sojeong Park ◽  
Jungkuk Lee ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Primary Endpoint ◽  
Cardiac Death ◽  
Cardiovascular Events ◽  
Coronary Revascularization ◽  
Korean National Health Insurance

<b>Objective:</b> We investigate long term clinical efficacy of fenofibrate use on mortality and cardiovascular outcomes in patients with type 2 diabetes. <p><b>Research design and Methods: </b>We performed population based cohort study using data of Korean National Health Insurance from 2003 to 2014. Among 63727 participants with diabetes aged 40-79, 5057 users of fenofibrate only were compared with 5057 non-users of fenofibrate and/or omega-3 fatty acid with 1:1 propensity matching. Primary endpoint was composite of myocardial infarction, stroke, percutaneous coronary revascularization and cardiac death for median 3 years. </p> <p><b>Results:</b> Primary endpoint was significantly lower in fenofibrate users as compared to neither users, 13.4 vs. 15.5 per 1000 person years (hazard ratio [HR] 0.76, confidence interval [CI], 0.62-0.94, P=0.010). Cardiac death (1.8 vs. 3.1 per 1000 person years [HR 0.59, CI, 0.352- 0.987, p=0.0446]), all cause death (7.6 vs. 15.3 per 1000 person years [HR 0.437, CI, 0.340 -0.562, p<0.0001]), and stroke (6.5 vs. 8.6 per 1000 person years [HR 0.621, CI, 0.463-0.833, P=0.0015]) were significantly lower in fenofibrate group. As the duration of fenofibrate use stratified by quartiles (Q1-4), the risk decreased in Q4 with HR of 0.347 (95% CI 0.226-0.532, P<0.0001). In subgroup analysis, the favoring effect of fenofibrate is sustained consistently across all subset of patients including those classified by LDL-C, HDL-C and TG levels.</p> <p><b>Conclusions:</b> Use of fenofibrate was associated with lower rate of total and cardiac mortality and cardiovascular events in type 2 diabetes patients for 3 year follow-up in real world large populations.</p>

scholarly journals Predictive Factors on the Incidence of Heart Failure in Patients with Ischemic Heart Disease: Using a 10-Year Population-Based Korea National Health Insurance Cohort Data

2020 ◽  
Vol 17 (22) ◽  
pp. 8670
Author(s):  
Seon Young Hwang ◽  
Kyung Ae Kim ◽  
Oh Jong Choi
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Health Insurance ◽  
Ischemic Heart Disease ◽  
National Health Insurance ◽  
National Health ◽  
Ischemic Heart ◽  
Rank Test ◽  
Diabetic Patients ◽  
Men And Women

Early risk stratification and preventative strategies are required in patients with ischemic heart disease (IHD) to prevent heart failure (HF). We aimed to investigate the rate of progression to HF and to investigate the factors predicting the development of HF in a population with IHD for 10 years. A descriptive study was conducted using Korea National Health Insurance Service-National Sample Cohort (NHI-NSC) data (2005–2015). Among the patients diagnosed with IHD for the first time in 2005–2006, 2271 men and 2037 women who responded to the health check-up survey were finally selected. Cox Proportional Hazard regression analyses and the Kaplan–Meier survival analysis were used. HF incidence rates were 5.1% in men and 8.0% in women. The mean duration of transition to HF was 4.85 ± 2.73 years in men and 4.73 ± 2.73 years in women. The non-incidence rate of HF was higher in men than in women (Log-rank test, p = 0.0003). Bivariate analyses showed that older age, prevalence of hypertension and diabetes, less alcohol, and lower physical exercise were associated with the incidence of HF in both men and women. Multivariate analyses found that HF incidence in aged subjects ≥70 years was 1.46 times higher in men and 1.44 times higher in women compared to those in their 30 s (p < 0.001). Prevalence of hypertension reduced the incidence of HF by 0.78 and 0.87 for men and women, respectively. The prevalence of diabetes increased 1.23 times only in men. These findings suggest that special attention such as periodic counseling and education is needed to prevent progression to HF in elderly and diabetic patients during follow-up after IHD.

scholarly journals Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data

2021 ◽  
Vol 18 (8) ◽  
pp. 4106
Author(s):  
Yunjeong Jang ◽  
Donghyun Jee ◽  
Donghwan Lee ◽  
Nam-Kyong Choi ◽  
SeungJin Bae
Keyword(s):  
Health Insurance ◽  
Retrospective Study ◽  
Medication Adherence ◽  
National Health Insurance ◽  
National Health ◽  
Open Angle Glaucoma ◽  
Medication Possession Ratio ◽  
Open Angle ◽  
Duration Of Therapy ◽  
The Mean

This study aimed to analyze medication adherence and persistence among open-angle glaucoma patients in Korea. A retrospective study was conducted using the Korean National Health Insurance (NHI) claims database from 2016 to 2019. Newly diagnosed open-angle glaucoma patients who were prescribed with the intraocular pressure (IOP)-lowering eyedrops were included. Adherence was measured using the medication possession ratio (MPR), and persistence was measured using the duration of therapy during the 24 month follow-up period. During the study period, 14,648 open-angle glaucoma patients were identified, and 3118 (21.3%) and 4481 patients (30.6%) were adherent to and persistent with their glaucoma treatment, respectively. The mean MPR was 48.8%, and the mean duration of therapy was 357.2 days. Logistic regression analysis showed that patients who are older, female, using prostaglandins as the index medication, and visiting secondary or tertiary hospitals were significantly associated with greater rates of adherence (odds ratio (OR) = 1.21, 1.12, 1.27, and 1.73, respectively) and persistence (OR = 1.11, 1.17, 1.16, 1.17, and 1.36, respectively) during the study period. Patients with open-angle glaucoma in Korea had substandard medication adherence and discontinued their treatment. Ophthalmologists should pay more attention to younger, male patients to improve adherence.

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