title: Consumption of pharmaceutical drugs in exception region of separation for drug prescribing and dispensing program in South Korea.
abstract: BACKGROUND
  In the year 2000, the South Korean government introduced a program for separation of drug prescribing and dispensing. The goals of the program are to reduce misuse of drugs and to contain drug expenditures. The government also designated exception regions for the program to reduce the inconvenience for people who reside in areas with a shortage of health care resources. However, according to government reports, many adverse events related to drug misuse occurred in these exception regions after the program reforms were introduced. Therefore, it is worth investigating the factors that relate to drug consumption so that misuse in exception regions can be reduced.
  
  
  METHODS
  Data from medical institutions, detailed drug supply data, and community health survey data were included in the analysis. Multilevel linear regression analysis using mixed models that included pharmacy-and regional-level variables were used to examine the associations regarding the percentages of drug types consumed (i.e., antipyretic, analgesic, anti-inflammatory drugs, psychotropic drugs, adrenal cortical hormones, and antibiotics).
  
  
  RESULTS
  The data used in this analysis were from a total of 16,455 pharmacies. There were 1.9 % pharmacies from program exception regions and 98.1 % pharmacies from program application regions. Compared with the pharmacies in the program application regions, the exception region pharmacies had higher values for percent consumption of the antipyretic, analgesic, anti-inflammatory drugs category, and of the adrenal cortical hormones category (antipyretic, analgesic, anti-inflammatory drugs = β: 3.19, Standard Error (SE): 0.82, t: 3.88, p-value < 0.05; adrenal cortical hormones = β: 0.72, SE: 0.07, t: 9.92, p-value < 0.05).
  
  
  CONCLUSIONS
  Our results suggested that pharmacies in exception regions supplied more antipyretic, analgesic, anti-inflammatory drugs, and more adrenal cortical hormones compared with the pharmacies where separation of drug prescribing and dispensing had been implemented. Health care professionals and health policy makers should consider management of health care expenditure by the category of drugs consumed, especially in program exception regions.
authors.affiliation: Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea. himiyaa@hiramail.net.|Health Insurance Review and Assessment Service, Seoul, Republic of Korea. himiyaa@hiramail.net.
authors.forename: Sang Mi
authors.initials: SM
authors.lastname: Yuk
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea. kthan@yuhs.ac.|Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea. kthan@yuhs.ac.
authors.forename: Kyu-Tae
authors.initials: KT
authors.lastname: Han
authors.affiliation: Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Korea. sunjkim0623@gmail.com.
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea. woorimk@yuhs.ac.|Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea. woorimk@yuhs.ac.
authors.forename: Woorim
authors.initials: W
authors.lastname: Kim
authors.affiliation: Department of Health Services Administration, Yuhan University, Bucheon, Republic of Korea. sohnty@yuhan.ac.kr.
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Sohn
authors.affiliation: Department of Preventive Medicine, CHA University, Pochon, Republic of Korea. BYJUN@yuhs.ac.
authors.forename: Byungyool
authors.initials: B
authors.lastname: Jeon
authors.affiliation: Gyeonggi Infectious Disease Control Center, Seongnam, Republic of Korea. gidcc_kym@gidcc.or.kr.
authors.forename: Young-Man
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea. ecpark@yuhs.ac.|Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. ecpark@yuhs.ac.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D056910:Republic of Korea; D011795:Surveys and Questionnaires