Department of Pharmacology, Maulana Azad Medical College, New Delhi, India.
Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
Indian J Med Res. 2024 Feb 1;159(2):143-152. doi: 10.4103/ijmr.ijmr_2507_21. Epub 2024 Apr 4.
Expenditure on healthcare is a major concern in the geriatric age group. The current study was carried out to assess the expenditure patterns on medicines utilized in geriatric inpatients.
An observational study was conducted on 1000 geriatric inpatients, aged ≥60 yr, admitted to the medicine unit. Data were collected regarding demographic characteristics, prescribed medicines, expenditure incurred on medicines, appropriateness of medicines prescribed and adverse drug reactions (ADRs). Appropriateness of the prescribed medicines was determined using the American Geriatrics Society 2015 Updated Beers Criteria.
Geriatric inpatients comprised 41.3 per cent of the total individuals admitted in the ward during the study period. A total of 8366 medicines were prescribed in 127 formulations. The total expenditure on prescribed medicines was INR 1,087,175 with a per capita expenditure of INR 1087.17. Parenteral medicines accounted for 91 per cent of the expenditure on medicines. Maximum expenditure (70%) was incurred on 11.9 per cent of the medicines prescribed. The per capita expenditure was significantly higher in individuals with comorbidities (P=0.03) and those who had a longer duration of hospital stay (P<0.0001). About 28.1 per cent prescriptions were inappropriate. ADRs (140) were observed in 139 (13.9%) inpatients. Individuals with inappropriate medicines prescriptions and ADRs had a longer duration of hospital stay and more number of medicines prescribed.
Comorbidities, prolonged hospitalization, polypharmacy, inappropriate medicines and parenteral medicines being prescribed contribute to increased expenditure on medicines in geriatric inpatients. In view of the rising number of geriatric inpatients, there is a need to frame a drug policy for them along with surveillance of expenditure on prescribed medicines. This needs to be treated as a priority.
医疗保健支出是老年人群体的主要关注点。本研究旨在评估老年住院患者使用药物的支出模式。
对 1000 名年龄≥60 岁、入住内科病房的老年住院患者进行了一项观察性研究。收集了人口统计学特征、处方药物、药物支出、处方药物的适宜性和药物不良反应（ADR）的数据。使用美国老年医学会 2015 年更新的 Beers 标准来确定处方药物的适宜性。
在研究期间，老年住院患者占病房总住院人数的 41.3%。共开具了 127 种制剂的 8366 种药物。开具药物的总支出为 1087175 卢比，人均支出为 1087.17 卢比。注射药物占药物支出的 91%。最多的支出（70%）发生在开具的 11.9%的药物上。患有合并症的个体（P=0.03）和住院时间较长的个体（P<0.0001）的人均支出明显更高。约 28.1%的处方是不适当的。在 139 名（13.9%）住院患者中观察到 140 例 ADR。使用不适当药物处方和发生 ADR 的患者住院时间更长，开具的药物数量更多。
合并症、延长住院时间、多种药物治疗、不适当的药物处方和使用注射药物都会导致老年住院患者的药物支出增加。鉴于老年住院患者人数不断增加，需要为他们制定药物政策，并监测开具药物的支出。这需要作为优先事项对待。
