Drug costs and use in VHA nursing homes: a national overview of long-stay residents.
OBJECTIVE
The aim of this study was to provide national annualized estimates of drug costs and use by drug classes for long-stay nursing home (NH) residents.


METHODS
National, descriptive, secondary data analysis.


METHODS
National, Veterans Health Administration (VHA), 136 NHs.


METHODS
Our study population consisted of 6554 VHA long-stay NH residents, identified from the Minimum Data Set (MDS), who had an annual assessment during FY 2005 linked with 8,847,561 inpatient pharmacy claims.


METHODS
Descriptive statistics of the annual drug costs and use by VHA therapeutic drug classes obtained from FY 2005 national pharmacy claims linked at the individual resident level.


RESULTS
The total cost of the drugs was $23,782,717 in 326 drug classes for 6554 VHA NH residents. Average annual drug cost was $3629 per resident (99% Confidence Interval [CI], $3343-$3915). The top 20 drug classes accounted for nearly 70% of total drug costs for long-stay NH residents. Approximately three quarters (73.3%) of these residents received a non-opioid analgesic (eg, acetaminophen, aspirin). Over half of these residents received antidepressants (selective serotonin reuptake inhibitors [SSRIs]) (54.3%), or other anti-infective drugs (eg, bacitracin, ciprofloxacin) (53.3%).


CONCLUSIONS
This is the first national study of drug costs and use for long-stay veterans in VHA NHs. It is essential in any study analyzing drug costs and use in NH patients to differentiate long-stay residents from short-stay patients. This kind of detailed cost and use analysis has implications for projecting future costs associated with the Medicare Part D prescription benefit for dually eligible NH residents.
French
Dustin D
DD
VISN-8 Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa, FL 33612, USA. Dustin.French@va.gov
Campbell
Robert R
RR
Spehar
Andrea M
AM
Rubenstein
Laurence Z
LZ
Cunningham
Francesca E
FE
D016527:Drug Costs; D004363:Drug Utilization; D006787:Hospitals, Veterans / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D009735:Nursing Homes / Q000191:economics / Q000458:organization & administration*; D004364:Pharmaceutical Preparations / Q000191:economics; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data
D004364:Pharmaceutical Preparations