Vivas Consuelo, DJJ.; Guadalajara Olmeda, MN.; Barrachina Martínez, I.; Trillo-Mata, J.; Usó-Talamantes, R.; De La Poza, E. (2011). Explaining primary health care pharmacy expenditure using classification of medications for chronic conditions. Health Policy. 103(1):9-15. https://doi.org/10.1016/j.healthpol.2011.08.014
Por favor, use este identificador para citar o enlazar este ítem: http://hdl.handle.net/10251/37258
Title:
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Explaining primary health care pharmacy expenditure using classification of medications for chronic conditions
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Author:
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Vivas Consuelo, David José Juan
Guadalajara Olmeda, María Natividad
Barrachina Martínez, Isabel
Trillo-Mata, José-Luis
Usó-Talamantes, Ruth
De la Poza, Elena
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UPV Unit:
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Universitat Politècnica de València. Departamento de Economía y Ciencias Sociales - Departament d'Economia i Ciències Socials
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Issued date:
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Abstract:
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Background
The Valencian Autonomous Community (Spain) has implemented a scheme of purchasing services with the participation of public and private providers. Five districts are managed using public¿private partnership. ...[+]
Background
The Valencian Autonomous Community (Spain) has implemented a scheme of purchasing services with the participation of public and private providers. Five districts are managed using public¿private partnership. The financing model is capitation and inter-center invoice. The pharmaceutical benefits are not included in the per capita assignment.
Objectives
Modeling and explaining pharmacy expenditure using electronic prescriptions drug data.
Methods
A database of electronic prescription corresponding to 625,246 patients between November 2008 and October 2009 was used to run four linear models that explain the pharmaceutical expenditures. We take as dependent variable the neperian log of total pharmacy annual cost per patient in the primary health setting. The independent variables used combined demographics with revised classification in 18 chronic conditions obtained from the anatomical therapeutic chemical classification index (ATC).
Results
The retrospective model selected included: gender, pharmaceutical co-payment status and 8 dummy variables for the number of chronic conditions of each patient from 1 to 8 or more. The goodness-of-fit achieved is measured in R2 of 57%.
Conclusions
These models must be considered in the current capitation system for pharmaceutical budgeting in a primary care setting established at regional level, as is the case in the Valencian Autonomous Community. The use of diagnostics and information regarding hospital encounters appears to be a complementary option for refining models of capitation of pharmaceutical and total health expenditure.
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Subjects:
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Prescribed drugs
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Pharmaceutical expenditure
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Chronic condition
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Risk adjustment
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Capitation payments
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Copyrigths:
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Reserva de todos los derechos
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Source:
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Health Policy. (issn:
0168-8510
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DOI:
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10.1016/j.healthpol.2011.08.014
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Publisher:
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Elsevier
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Publisher version:
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http://dx.doi.org/10.1016/j.healthpol.2011.08.014
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Thanks:
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The authors thank the General Direction of Pharmacy of the Valencian Department of Health for financial support and the working group for providing the data set. The opinions expressed in this paper are those of the authors ...[+]
The authors thank the General Direction of Pharmacy of the Valencian Department of Health for financial support and the working group for providing the data set. The opinions expressed in this paper are those of the authors and do not necessarily reflect those of the afore-named. Any errors are the authors' responsibility. We would also like to thank the two anonymous reviewers for their comments, which helped greatly to improve this paper.
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Type:
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Artículo
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