Analysis of Prescriptions for Asthma at Primary Health Care Using National Health Insurance Database

건강보험자료를 이용한 의원의 천식처방 분석

  • 이의경 (한국보건사회연구원 보건의료연구실) ;
  • 박은자 (한국보건사회연구원 보건의료연구실) ;
  • 배은영 (한국보건사회연구원 보건의료연구실) ;
  • 이숙향 (숙명여자대학교 임상약학대학원)
  • Published : 2003.08.01

Abstract

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20% of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3%, and that for oral theophylline was 46.9%. Oral steroids were prescribed for the 28.2% of the claims. Utilization of inhalers was low for both bronchodilators (20.3%, beta-2 agonists inhalers), and steroids (8.4% steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0% for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0%, antitussives 65.3%, antihistamines 25.3% and analgesics 29.4%, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

Keywords

References

  1. 약제평가 건강보험심사평가원
  2. 약제급여 심사평가정책의 개선방안 정책토론회 자료 약제적정성 평가정책의 문제점과 개선방안 이선희
  3. Br. Med. J. v.302 Prevalence of asthma in melbourne school children: change over 26 years Robertson, C. F. (et al.) https://doi.org/10.1136/bmj.302.6785.1116
  4. BMJ v.321 International 20 year trends in the prevalence of asthma and hay fever in adults; the midspan family study surveys of parents and offspring Upton, M. N.(et al.) https://doi.org/10.1136/bmj.321.7253.88
  5. J. Asthma v.25 no.2 Prevalence of childhood athma in taipei, taiwan, and other asian pacific countries Hsieh, K. H.;Shen, J. J. https://doi.org/10.3109/02770908809071357
  6. 가정의학회지 v.19 no.11 한국의 기관지천식 치료지침 박해심
  7. 진료경향조사 건강보험심사평가원
  8. Aust. N. Z. J. Med. v.27 Asthma prevalence, morbidity and management practice in south austria Adams, R.(et al.) https://doi.org/10.1111/j.1445-5994.1997.tb00997.x
  9. BMJ v.300 no.6735 Has the prevalence of asthma increased in children? evidence from the national study of health and growth 1973-86 Burney, P. G.;Chinn, S.;Rona, R. J. https://doi.org/10.1136/bmj.300.6735.1306
  10. J. Allergy Clin. Immunol. The health economics of asthma and rhinitis. assessing the economic impact Weiss, K. B.;Sullivan, S. D.
  11. Am. J. Respir. Crit. Care Med. v.154 National asthma education and prevention program working group report on the cost effectiveness of asthma care Sullivan, S. (et al.)
  12. NIH publication No. 97~4051 National Asthma and Prevention Program, Expert panel Report 2.Guidelines for the diagnosis and management of asthma NHLBI
  13. 천식진료지침 대한결핵 및 호흡기학회
  14. 소아에 대한 천식진료지침 대한소아알레르기 및 호흡기학회
  15. 의약분업 전후의 의약품 오남용 실태 분석 장선미;이의경;김윤;한은아;배은영;김재용;이연희;신창우;송윤미;강영호;황경화
  16. Australia's national medicines policy: using indicators to monitor implementation and effect PHARM (Pharmaceutical Health And Rational use of Medicines Committee)
  17. Expert panel Report: Guidelines for the diagnosis and management of asthma NAEPP, NAEPP (National Asthma Education and Prevention Program)
  18. 의약분업 전호 약제비 변동요인 분석과 정책과제 이의경;장선미;신종각;박정영