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.

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.

Burden of Clostridium difficile Infections in French Hospitals in 2014 From the National Health Insurance Perspective

2017 ◽  
Vol 38 (8) ◽  
pp. 906-911 ◽  
Author(s):  
Soline Leblanc ◽  
Cécile Blein ◽  
Antoine Andremont ◽  
Pierre-Alain Bandinelli ◽  
Thibaut Galvain
Keyword(s):  
Health Insurance ◽  
Clostridium Difficile ◽  
National Health Insurance ◽  
National Health ◽  
Primary Diagnosis ◽  
Secondary Diagnosis ◽  
National Insurance ◽  
Insurance Perspective ◽  
Hospital Stays ◽  
The Mean

OBJECTIVETo describe the hospital stays of patients with Clostridium difficile infection (CDI) and to measure the hospitalization costs of CDI (as primary and secondary diagnoses) from the French national health insurance perspectiveDESIGNBurden of illness studySETTINGAll acute-care hospitals in FranceMETHODSData were extracted from the French national hospitalization database (PMSI) for patients covered by the national health insurance scheme in 2014. Hospitalizations were selected using the International Classification of Diseases, 10threvision (ICD-10) code for CDI. Hospital stays with CDI as the primary diagnosis or the secondary diagnosis (comorbidity) were studied for the following parameters: patient sociodemographic characteristics, mortality, length of stay (LOS), and related costs. A retrospective case-control analysis was performed on stays with CDI as the secondary diagnosis to assess the impact of CDI on the LOS and costs.RESULTSOverall, 5,834 hospital stays with CDI as the primary diagnosis were included in this study. The total national insurance costs were €30.7 million (US $33,677,439), and the mean cost per hospital stay was €5,267±€3,645 (US $5,777±$3,998). In total, 10,265 stays were reported with CDI as the secondary diagnosis. The total national insurance additional costs attributable to CDI were estimated to be €85 million (US $93,243,725), and the mean additional cost attributable to CDI per hospital stay was €8,295±€17,163, median, €4,797 (US $9,099±$8,827; median, $5,262).CONCLUSIONCDI has a high clinical and economic burden in the hospital, and it represents a major cost for national health insurance. When detected as a comorbidity, CDI was significantly associated with increased LOS and economic burden. Preventive approaches should be implemented to avoid CDIs.Infect Control Hosp Epidemiol 2017;38:906–911

scholarly journals Primary Prevention of Cardiocerebrovascular Diseases and Related Deaths According to Statin Type

2020 ◽  
Vol 17 (17) ◽  
pp. 6309
Author(s):  
Joungyoun Kim ◽  
Hyeong-Seop Kim ◽  
Woojung Yang ◽  
Jae-woo Lee ◽  
Hee-Taik Kang
Keyword(s):  
Health Insurance ◽  
Retrospective Study ◽  
Primary Prevention ◽  
National Health Insurance ◽  
National Health ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Korean National Health Insurance ◽  
Composite Outcomes

(1) Background: Statin is the mainstay of treatment for the primary prevention of atherosclerotic cardiocerebrovascular diseases (CCVDs) in adults with hypercholesterolemia. This study aims to investigate the differences in effect on primary composite outcomes (CCVDs and CCVD-related deaths) among five statins in hypercholesterolemic individuals. (2) Methods: This retrospective study is based on the Korean National Health Insurance Service-National Health Screening Cohort. Participants, aged 40 to 69 years at baseline, were categorized into five statin-treated groups (pitavastatin, atorvastatin, rosuvastatin, simvastatin, and pravastatin) and two untreated groups (untreated hypercholesterolemia and no hypercholesterolemia). (3) Results: A total of 161,583 individuals was included. The median follow-up period was 8.2 years. Compared with the pitavastatin group, the hazard ratios (HRs; 95% confidence intervals (CIs)) for CCVDs and CCVD-related deaths of the atorvastatin, rosuvastatin, simvastatin, pravastatin, untreated hypercholesterolemia, and no-hypercholesterolemia groups were 0.969 (0.567–1.657), 0.988 (0.533–1.832), 0.862 (0.490–1.518), 0.906 (0.326–2.515), 2.665 (1.556–4.562), and 0.656 (0.388–1.110), respectively, in men and 1.124 (0.632–1.999), 1.119 (0.582–2.152), 1.324 (0.730–2.400), 1.023 (0.330–3.171), 2.650 (1.476–4.758), and 0.921 (0.522–1.625), respectively, in women, after being fully adjusted. (4) Conclusions: No significant differences among the five statins were observed, but there was an increased risk in untreated hypercholesterolemic individuals, for CCVDs and CCVDs-related deaths in individuals with hypercholesterolemia of either sex.

scholarly journals Medication-Taking Habit and Outcome of Glucosamine Sulfate for Osteoarthritis Patients Influenced by National Health Insurance Regulations in Taiwan

2019 ◽  
Vol 8 (10) ◽  
pp. 1734
Author(s):  
Chia-Hao Hsu ◽  
Nin-Chieh Hsu ◽  
Chia-Lung Shih ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Glucosamine Sulfate ◽  
Research Database ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
The Mean ◽  
First Time ◽  
To Receive

This study compared the dosage and different medication-taking habits of glucosamine sulfate (GS) for osteoarthritis patients and evaluated the influence of the National Health Insurance (NHI) prescription guidelines. The subjects were collected from the Taiwan NHI Research Database from 1 January 2004, to 31 December 2008, and 10,501 osteoarthritis patients were included. Then, 271 patients who continuously used nonsteroidal anti-inflammatory drug (NSAIDs) and started to receive glucosamine for the first time since 2005 (no glucosamine use in 2004) were compared with 593 age-matched patients who continuously used NSAIDs but never received any glucosamine drugs from 2004 to 2008. The mean treatment duration of the glucosamine-treated and NSAID-treated groups was 40.38 ± 7.89 and 45.82 ± 3.89 months, respectively. The most common medication-taking habit was 250 mg 3 times a day for 3 months and discontinued for 3 months. It was as indicated and covered by the NHI. Only 0.7% of patients used the recommended daily dosage of 1500 mg. Patients using GS surprisingly had a higher incidence rate of joint replacement surgery than those who did not use GS. The NHI prescription guidelines may cause patient selection bias, which decreases the efficacy of GS. Moreover, patients tend to have an altered medication-taking habit, with a daily dosage of 750 mg, which is lower than the recommended therapeutic dose.

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