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首页> 外文学位 >Inappropriate drug prescribing and related economic and clinical outcomes for Louisiana nursing home Medicaid beneficiaries.
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Inappropriate drug prescribing and related economic and clinical outcomes for Louisiana nursing home Medicaid beneficiaries.

机译：路易斯安那州疗养院医疗补助受益人的药物处方不当以及相关的经济和临床结果。

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Little direct assessment has been made of the quality of medication prescribing to elderly nursing home residents. Medicaid is a means of delivering medical care to eligible needy individuals. The study of elderly nursing home Medicaid beneficiaries is relevant to optimal use of Medicaid funds since expenditures for pharmaceutical and health care services for these nursing home residents are proportionately much higher than for any other group. The purpose of this project was to study the prescribing of inappropriate medications to the elderly Medicaid beneficiaries residing in Louisiana's Intermediate Care Facilities I (ICFs I) and its influence on relevant economic and clinical outcomes.; Relevant data for geriatric Medicaid beneficiaries in Louisiana's ICFs I for 1994 were extracted from three Medicaid files (Claim History file, Provider Master file and Drug file) containing a total of 1,430,629 records for 19,932 beneficiaries in the study population. Explicit criteria were used to identify inappropriate drugs. Hypertensive and diabetic beneficiaries in the study population were identified using the drug therapeutic classes.; The extracted data were analyzed using multiple linear and binomial logit regression models. Results of the study showed that the number of different drugs prescribed to a beneficiary was influenced by a beneficiary's geographic region and race and was likely to be higher for a beneficiary who used a larger number of physicians and pharmacies. The number of different inappropriate drugs prescribed to a beneficiary was influenced by a beneficiary's geographic region and age and was likely to be higher for a beneficiary who used a larger number of physicians and pharmacies and was prescribed a larger number of different drugs. The outcome measures, costs of pharmaceutical and health care services, number of inpatient hospital days and probability of beneficiary mortality, were influenced by sex, age, race and geographic region of a beneficiary. They were likely to be higher for a beneficiary who used a larger number of physicians and/or pharmacies and was prescribed a larger number of different inappropriate drugs.; It was concluded that the demographic and health care provider-related factors influenced the number of different drugs prescribed, the number of different inappropriate drugs prescribed and the economic and clinical outcomes for an elderly Medicaid beneficiary residing in a Louisiana ICF I. Avoiding prescribing of the inappropriate drugs or prescribing them in smallest possible numbers to a beneficiary may be cost-effective.
机译：几乎没有直接评估处方给老年人疗养院居民的药物质量。医疗补助是向合格的有需要的个人提供医疗服务的一种手段。对老年人疗养院医疗补助受益人的研究与医疗补助资金的最佳使用有关，因为这些疗养院居民用于药品和保健服务的支出成比例地远高于其他任何人群。该项目的目的是研究对居住在路易斯安那州中级医疗机构I（ICFs I）中的老年医疗补助受益人的不当用药处方及其对相关经济和临床结果的影响。 1994年路易斯安那州ICF I的老年医疗补助受益人的相关数据是从三个医疗补助文件（索赔历史记录文件，提供方主文件和药品档案）中提取的，这些文件共包含1,430,629条记录，涉及研究人群中的19,932名受益人。明确标准用于识别不适当的药物。使用药物治疗类别确定了研究人群中的高血压和糖尿病受益人。使用多个线性和二项式logit回归模型分析提取的数据。研究结果表明，给受益人开具的不同药物的数量受受益人的地理区域和种族的影响，对于使用大量医生和药房的受益人来说可能更高。给受益人开出的不同不当药物的数量受受益人的地理区域和年龄的影响，对于使用了更多医生和药房并且开出了更多不同药物的受益人，该数字可能更高。结果指标，受益人的性别，年龄，种族和地理区域影响着结局指标，药物和保健服务的成本，住院日数和受益人死亡的可能性。对于使用大量医生和/或药房并被开具大量不同不当药物的受益人来说，他们可能更高。结论是，与人口统计学和医疗保健提供者相关的因素影响了居住在路易斯安那州ICF I的老年医疗补助受益人开具的不同药物的数量，开具不同不当药物的数量以及经济和临床结果。不适当的药物或以尽可能少的数量向受益人开药可能具有成本效益。

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