title: Newness of drugs and use of HMO services by asthma patients.
abstract: OBJECTIVE
  To define newness of drug technology and show associations between two measures of newness and health service utilization.
  
  
  METHODS
  Healthcare use and changes in severity at each office visit were assessed for 1309 asthma patients from six health maintenance organizations (HMOs) during 1992. The age of each drug product, derived by subtracting its Food and Drug Administration (FDA) approval date from January 1, 1992, was used to construct two newness measures: the average age of all asthma drugs and, separately, all non-asthma drugs a patient used during the year and the percentages of a patient's asthma drugs from each of four time intervals of asthma drug breakthroughs. Service utilization variables included all primary care provider (PCP) visits, total prescription costs, emergency department (ED) visits, and hospitalizations.
  
  
  RESULTS
  Using either measure of drug newness, multivariate analyses showed an association between greater use of newer asthma drugs and lower overall drug costs and fewer PCP visits. A trend was found between greater use of newer asthma drugs and fewer hospitalizations and ED visits. Newer non-asthma medications were associated with fewer ED visits.
  
  
  CONCLUSIONS
  After controlling for patient and site variables, greater use of newer asthma drugs was associated with significantly lower drug costs and fewer PCP visits; associations with hospitalization rates and ED visits, although lower, were not significant.
authors.affiliation: Institute for Clinical Outcomes Research, University of Texas-Houston, School of Nursing, USA. shorn@isisicor.com
authors.forename: S D
authors.initials: SD
authors.lastname: Horn
authors.forename: P D
authors.initials: PD
authors.lastname: Sharkey
authors.forename: H W
authors.initials: HW
authors.lastname: Kelly
authors.forename: D L
authors.initials: DL
authors.lastname: Uden
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D001249:Asthma / Q000145:classification / Q000188:drug therapy* / Q000191:economics; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003363:Cost Control; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012720:Severity of Illness Index; D013678:Technology, Pharmaceutical; D014481:United States
chemical_list: D001993:Bronchodilator Agents