Jünger C, Rathmann W, Giani G
Heinrich-Heine-Universität, Abteilung Biometrie und Epidemiologie, Düsseldorf.
Gesundheitswesen. 1999 Dec;61(12):607-13.
With computerised data on drug prescriptions, which were collected among a sample of 362 internist, general and medical practitioners throughout Germany, the effects of the drug budget, based on the German Health Care Structure Reform Act (GSG), on diabetic patients were analysed. The data of 3053 diabetic patients (10% random sample) were compared with the same number of nondiabetic patients for the period of July 1992 to December 1994. The frequency of consultations per patient increased in both groups during the study period (p < 0.01). Diabetic patients had more contacts with the physicians than nondiabetic subjects (p < 0.01). The prescriptions and costs among the patients with diabetes decreased in the first six month of 1993 (-10%/ -16%). In the following time costs increased and exceeded the values of 1992 by about 13%. The costs per prescription decreased during the study period about 10%. The data show that costs as well as prescriptions per consultation between diabetic and nondiabetic patients remained in the same ratio. The proportion of consultations with > or = 1 prescription increased in diabetic patients after the GSG. A refusal to prescribe drugs in primary health care practices among diabetic patients was not observed. There was also no restriction on prescription drug use among diabetic patients compared with nondiabetics.
通过在德国各地362名内科医生、全科医生和执业医师样本中收集的药物处方计算机化数据,分析了基于德国医疗保健结构改革法案(GSG)的药物预算对糖尿病患者的影响。在1992年7月至1994年12月期间,将3053名糖尿病患者(10%随机样本)的数据与相同数量的非糖尿病患者的数据进行了比较。在研究期间,两组患者的人均就诊频率均有所增加(p<0.01)。糖尿病患者与医生的接触比非糖尿病患者更多(p<0.01)。糖尿病患者的处方量和费用在1993年的前六个月有所下降(-10%/-16%)。在接下来的时间里,费用增加,比1992年的值高出约13%。研究期间每张处方的费用下降了约10%。数据显示,糖尿病患者和非糖尿病患者每次就诊的费用以及处方量保持相同比例。在GSG实施后,糖尿病患者中开具≥1张处方的就诊比例有所增加。未观察到糖尿病患者在初级医疗保健机构拒绝开药的情况。与非糖尿病患者相比,糖尿病患者在使用处方药方面也没有受到限制。