Shin Sun Mi, Kim Eui Sook, Lee Hee Woo
Office of Global Health Leadership, University of Illinois at Chicago, USA.
J Prev Med Public Health. 2009 Nov;42(6):403-7. doi: 10.3961/jpmph.2009.42.6.403.
The amount of medical utilization by Medical Aid recipients was 3.7 times that of patients with Korean Medical Insurance. This study aims to describe the surplus medicine and the medication-related utilization, and to determine factors contributing to surplus medicine.
Among those who used copayment-free Class I Medical Aid in 2005, 146,880 subjects who were >/=19 year-old and received >365 days medical treatment per year were studied with their case managers by conducting face-to-face interviews. The analytic methods were description, chi-square, t-tests, ANCOVA and multiple logistic regressions.
Most subjects were female (68.6%), the elderly (62.5%), and the separated (61.6%), had an elementary graduation or less (74.8%), and had disabilities (33.2%). The percentage of subjects with surplus medicine was 18.5%. However, the percentage of females, the elderly, those with non-disabilities, the separated, the uneducated, those with a very poor perceived health status and those with an economical burden for medical treatment was 19.3%, 18.9%, 19.0%, 19.3%, 19.0%, 20.2% and 24.3%, respectively. For subjects with surplus medicine, averages for the number of used pharmacies, the pharmacy-visit days and the medication costs were 4.6 drugstores, 34.9 days and approximately 1,124 thousand Won(). These values were higher than those without surplus medicine (4.4 drugstores , 33.8 days, and Won()1,110 thousand, respectively). The odds ratios of the contributing factors to surplus medicine were female 1.11 (95% CI=1.07-1.14), the elderly 1.06 (95% CI=1.02-1.10), those with non-disabilities 1.08 (95% CI=1.05-1.12), the separated 1.14 (95% CI=1.10-1.18), the unmarried 1.12 (95% CI=1.07-1.18), the uneducated 1.03 (95% CI=1.01-1.08), those with a very poor perceived health status 1.04 (95% CI=1.01-1.08) and experiencing an economical burden for medical treatment 2.33 (95% CI=2.26-2.40).
18.5% of subjects had surplus medicine with a higher mean of medication cost. Therefore, health education and health promotion programs to prevent surplus medicine and to improve the appropriate usage of medication are necessary.
医疗救助受助者的医疗利用率是参加韩国医疗保险患者的3.7倍。本研究旨在描述剩余药品及与用药相关的利用率，并确定导致剩余药品的因素。
在2005年使用一类免费医疗救助的人群中，选取146,880名年龄≥19岁且每年接受治疗超过365天的受试者，与他们的个案管理员进行面对面访谈。分析方法包括描述性统计、卡方检验、t检验、协方差分析和多元逻辑回归。
大多数受试者为女性（68.6%）、老年人（62.5%）、分居者（61.6%），小学及以下学历（74.8%），且有残疾（33.2%）。有剩余药品的受试者比例为18.5%。然而，女性、老年人、非残疾者、分居者、未受过教育者、自我感觉健康状况很差者以及有医疗经济负担者的比例分别为19.3%、18.9%、19.0%、19.3%、19.0%、20.2%和24.3%。对于有剩余药品的受试者，使用药房的数量、去药房的天数和用药费用的平均值分别为4.6家药店、34.9天和约11.24万韩元。这些值高于没有剩余药品的受试者（分别为4.4家药店、33.8天和11.10万韩元）。导致剩余药品的因素的比值比为女性1.11（95%置信区间=1.07-1.14），老年人1.06（95%置信区间=1.02-1.10），非残疾者1.08（95%置信区间=1.05-1.12），分居者1.14（95%置信区间=1.10-1.18），未婚者1.12（95%置信区间=1.07-1.18），未受过教育者1.03（95%置信区间=1.01-1.08），自我感觉健康状况很差者1.04（95%置信区间=1.01-1.08）以及有医疗经济负担者2.33（95%置信区间=2.26-2.40）。
18.5%的受试者有剩余药品，且用药费用均值更高。因此，有必要开展健康教育和健康促进项目，以预防剩余药品并改善用药的合理使用。
