Changes in drug prescription utilization for diabetic and hypertensive outpatients after initiation of the National Health Insurance's Global Budget Program in Taiwan.
BACKGROUND
To examine changes in medicine utilization and prescription trends for diabetic (DM) and hypertensive (HT) patients upon initiation of the National Health Insurance (NHI) global budget (GB) program in Taiwan.


METHODS
Data on hospital-based outpatient prescriptions for DM and HT from the Taipei branch before and after the GB were analyzed from January 2002 to December 2004. A secondary analysis of reimbursed data, with descriptive and trend analyses of the four indicators, daily oral medication cost, daily tablets used, medicine items per prescription, and tablet cost, was conducted.


RESULTS
The comparisons of before and after the GB were as follows: Daily oral medication cost increased from US $0.585 to $0.956 (64%) for the DM group and from $1.01 to $1.07 (6.12%) for the HT group. The increments for daily used tablets, medicine items per prescription, and tablet cost were 33.3%, 17.9%, and 26.5% for the DM group and 6.65%, 3.31%, and 0.27% for the HT group. Indicators for the DM group not only increased significantly compared with those of the HT group, but also had higher adjusted beta coefficients. The comparisons of before and after the GB showed that the increments for the DM group decreased slightly, but not those for the HT group.


CONCLUSIONS
The indicators for DM were significantly higher than those of HT group during the implementation phase of the GB. The GB program implemented by the NHI in Taiwan slightly slowed the trend of hospital-based ambulatory prescription costs of DM, but not HT.
Chou
Chih-Chieh
CC
Department of Family and Community Health, Tri-Service General Hospital, Taipei, Taiwan.
Hu
Kun-Yi
KY
Wu
Ni-Ren
NR
Cheng
Yeong-Huang
YH
Loh
Ching-Hui
CH
Yeh
Ming-Kung
MK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000191:economics; D002648:Child; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000191:economics; D016527:Drug Costs; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics; D007004:Hypoglycemic Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D013222:State Medicine; D013624:Taiwan
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents