Chun Sung-Youn, Park Hye-Ki, Han Kyu-Tae, Kim Woorim, Lee Hyo-Jung, Park Eun-Cheol
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
BMC Health Serv Res. 2017 Jul 12;17(1):478. doi: 10.1186/s12913-017-2434-6.
We evaluated the effectiveness of a policy allowing for the sale of over-the-counter drugs outside of pharmacies by examining its effect on number of monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine.
We used medical claims data extracted from the Korean National Health Insurance Cohort Database from 2009 to 2013. The Korean National Health Insurance Cohort Database comprises a nationally representative sample of claims - about 2% of the entire population - obtained from the medical record data held by the Korean National Health Insurance Corporation (which has data on the entire nation). The analysis included26,284,706 person-months of 1,042,728 individuals. An interrupted-time series analysis was performed. Outcome measures were monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. To investigate the effect of the policy, we compared the number of monthly visits before and after the policy's implementation in 2012.
For acute upper respiratory infections, monthly outpatient visits showed a decreasing trend before the policy (ß = -0.0003);after it, a prompt change and increasing trend in monthly outpatient visits were observed, but these were non-significant. For dyspepsia, the trend was increasing before implementation (ß = -0.0101), but this reversed after implementation(ß = -0.007). For migraine, an increasing trend was observed before the policy (ß = 0.0057). After it, we observed a significant prompt change (ß = -0.0314) but no significant trend.
Deregulation of selling over-the-counter medication outside of pharmacies reduced monthly outpatient visits for dyspepsia and migraine symptoms, but not acute upper respiratory infections.
我们通过研究一项允许在药店以外销售非处方药的政策对急性上呼吸道感染、消化不良和偏头痛每月门诊就诊次数的影响，来评估该政策的有效性。
我们使用了从2009年至2013年韩国国民健康保险队列数据库中提取的医疗理赔数据。韩国国民健康保险队列数据库包含从韩国国民健康保险公会所持有的病历数据中获取的具有全国代表性的理赔样本——约占总人口的2%（该机构拥有全国的数据）。分析纳入了1,042,728名个体的26,284,706人月的数据。进行了中断时间序列分析。结果指标为急性上呼吸道感染、消化不良和偏头痛的每月门诊就诊次数。为了研究该政策的效果，我们比较了2012年政策实施前后的每月就诊次数。
对于急性上呼吸道感染，在政策实施前每月门诊就诊次数呈下降趋势（β = -0.0003）；实施后，观察到每月门诊就诊次数有迅速变化且呈上升趋势，但这些变化不显著。对于消化不良，在实施前趋势呈上升（β = -0.0101），但实施后逆转（β = -0.007）。对于偏头痛，在政策实施前观察到呈上升趋势（β = 0.0057）。实施后，我们观察到有显著的迅速变化（β = -0.0314）但无显著趋势。
放宽药店以外非处方药的销售规定减少了消化不良和偏头痛症状的每月门诊就诊次数，但对急性上呼吸道感染无效。
