• Title/Summary/Keyword: inappropriate medications

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Provider Variation in Diagnosing Complications of Upper Respiratory Infection in Korean Children (소아 급성상기도감염 합병증 진단의 공급자간 편차)

  • Choi, Hyug-Yong;Park, Jung-Hoo;Yoo, Do-Young;Lim, Myeon-Gil;Kim, Min-Ah;Kim, Nam-Gil;Cho, Hyun-Joo
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.1
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    • pp.181-197
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    • 2013
  • Objectives : This study aimed to assess the differences in treatment behavior by reviewing data of a medical institution that studies treatment behavior in URI and assessing the treatment efficacy in Korea. Methods : We analyzed the behavior of medical customers and providers of upper respiratory infection medications using the NPS published by the Health Insurance Review Assessment Service. We created an operational definition for complications, and confirmed the difference in complication distribution between medical specialties. We also performed a multivariate analysis using a mixed model to elucidate the factors influencing the occurrence of complications. Results : The outcomes of analyzing factors to influence the difference in practice patterns of the diagnosing URI between the physicians are as follows; (1) Analysis of antibiotics prescriptions rate showed significant difference from medical departments (pediatrics; 49.7%, internal medicine; 54.2%, otorhinolaryngology; 69.6%, family medicine; 61.6%, general surgery; 57.5%, p<0.001). Analysis of steroid prescriptions rate showed significant difference from medical departments (pediatrics; 3.8%, internal medicine; 4.5%, otorhinolaryngology; 5.4%, family medicine; 3.0%, general surgery; 11.2%, p<0.001). (2) In patients who visited medical institutes with the common cold, the complication distribution differed according to the medical specialty, which suggests that specific complications arise depending on the particular medical specialty (p<0.001). (3) Moreover, through multivariate analysis, we found that the complication rate is higher in clinics than in hospitals, depending on the institute's size. (p<0.001; odds ratio of 4.67 in clinics than in hospitals, 95% CI 2.66-8.21) Conclusions : We observe a deviation between the behavior of patients diagnosed with URI and medication providers. This may arise from the interaction between providers and consumers, wherein the complications are associated with the choice of outpatient department and the prevention of cutting incentives. These findings suggest that the health policies should be improved to prevent inappropriate medical practice in the treatment of pediatric URI.

Cost Avoidance and Clinical Pharmacist Interventions on Hospitalized Patients in Hematologic malignancies (혈액종양 입원 환자 대상 임상약사의 처방중재활동 및 회피비용 분석)

  • Kim, Ye Seul;Hong, So Yeon;Kim, Yoon Hee;Choi, Kyung Suk;Lee, Jeong Hwa;Lee, Ju-Yeun;Lee, Euni
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.215-225
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    • 2022
  • Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.