Drug overprescription in nursing homes: an empirical evaluation of administrative data.
A widely discussed shortcoming of long-term care in nursing homes for the elderly is the inappropriate or suboptimal drug utilization, particularly of psychotropic drugs. Using administrative data from the largest sickness fund in Germany, this study was designed to estimate the effect of institutionalization on the drug intake of the frail elderly. Difference-in-differences propensity score matching techniques were used to compare drug prescriptions for the frail elderly who entered a nursing home with those who remained in the outpatient care system; findings suggest that nursing home residents receive more doses of antipsychotics, antidepressants, and analgesics. The potential overprescription correlates with estimated drug costs of about €87 million per year.
RWI Essen, Essen, Germany. Magdalena.Stroka@rub.de.|Department of Economics, Ruhr-Universität Bochum, Universitätsstr. 150, 44801, Bochum, Germany. Magdalena.Stroka@rub.de.|WINEG-Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany. Magdalena.Stroka@rub.de.
Magdalena A
MA
Stroka
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000700:Analgesics / Q000008:administration & dosage / Q000191:economics; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000191:economics; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000191:economics; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005252:Fees, Pharmaceutical; D005260:Female; D005858:Germany; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017059:Models, Econometric; D009735:Nursing Homes / Q000706:statistics & numerical data*; D000067490:Prescription Drug Overuse / Q000191:economics* / Q000706:statistics & numerical data*; D057216:Propensity Score
D000700:Analgesics; D000928:Antidepressive Agents; D014150:Antipsychotic Agents
Drug over- and undersupply; Expenditures; Medical costs; Medication errors; Patient safety