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Trends and Appropriateness of Outpatient Prescription Drug Use in Elderly Veterans
Yakhak Hoeji 2019;63(3):164-172
Published online June 30, 2019
© 2019 The Pharmaceutical Society of Korea.

Iyn-Hyang Lee*, Nam Kyung Je**, and Yeryeong Hwang*

*College of Pharmacy, Yeungnam University, **College of Pharmacy, Pusan National University
Correspondence to: #Iyn-Hyang Lee, College of Pharmacy, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea Tel: +82-53-810-2829, Fax:+82-53-810-4654 E-mail: leeiynhyang@ynu.ac.kr
Received April 26, 2019; Revised May 31, 2019; Accepted June 12, 2019.
Abstract
This study aimed to analyze national claims data of elderly veterans to generate scientific evidence over the trends and appropriateness of their drug utilization in outpatient setting. National claims data of elderly veterans during 2014-2015 were provided by the Health Insurance Review & Assessment (HIRA). We selected two comparable groups through random sampling and matching the data between elderly veterans and National Health Insurance (NHI) or Medical Aid (MAID) patients. We made comparisons among groups in drug use and costs using multivariate gamma regression models, and in two inappropriate prescribing indicators using multivariate logistic regression models. Given the same environment, elderly veteran patients, in comparison to NHI patients, visited medical institution less with 0.82 times, had 1.83 times more drug use, and paid 1.22 times more drug costs (p<0.05). In comparison to elderly MAID patients, elderly veteran patients visited medical institution less with 0.94 times, had 1.24 times more drug use, and paid 1.04 times more drug costs (p<0.05). Elderly veteran patients were exposed to the risk of potentially inappropriate medications (PIM) prescribed 1.3 times more than comparison groups (OR=1.26 in those compared to NHI patients, or 1.28 in those compared to MAID patients, p<0.0001), and to the risk of therapeutic duplication 1.6 times more than comparison groups (OR=1.62 in those compared to NHI patients, or 1.56 in those compared to MAID patients, p<0.0001). There were greater worries in drug use behaviors of elderly veteran patients over inefficient and potentially unsafe drug utilization.
Keywords : elderly, veterans, drug utilization, potentially inappropriate medications, therapeutic duplication


June 2019, 63 (3)
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