title: Hospitalization rates as outcome indicators of national medicinal drug policies: the example of gastrointestinal ulcer.
abstract: National medicinal drug policies are employed around the world as a means of maximizing the benefits of medication use. An essential component to the implementation of these policies is their concurrent evaluation, which informs future policy implementation and strategic directions. The overall effect of the policy can be measured by monitoring changes in health outcomes and hospitalization rates for conditions that can be managed with appropriate medication use have been proposed as a potential outcome indicator of national medicinal drug policies. In this paper, a method for establishing the validity of this indicator is described. The method enables suitable conditions to be identified and takes into account potential confounding factors. To demonstrate this a case study of hospitalization rates for gastrointestinal ulcer is presented. The analysis shows that hospitalization rates are suitable as outcome indicators of quality medication use where the hospitalization rate is not confounded by changes in the population profile, disease prevalence and severity, diagnosis, hospital based policies, coding practices, environmental factors or hospital based treatments, but is responsive to changes in the utilization of medication. This method could be used in many countries for determining relevant and valid indicators for monitoring health outcomes.
authors.affiliation: School of Pharmacy and Medicinal Sciences, University of South Australia, North Terrace, Adelaide 5000, South Australia, Australia.
authors.forename: E E
authors.initials: EE
authors.lastname: Roughead
authors.forename: A L
authors.initials: AL
authors.lastname: Gilbert
authors.forename: J G
authors.initials: JG
authors.lastname: Primrose
authors.forename: L N
authors.initials: LN
authors.lastname: Sansom