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HEALTH CARE USE & POLICY STUDIES |
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PHP1 |
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ANALYZING PRODUCT
DIFFERENTIATION IN FOUR ARGENTINEAN PHARMACEUTICAL
MARKETS
Maceira DA, Center for the Study of the
State and Society (CEDES), Ciudad Autonoma de
Buenos Aires, Buenos Aires, Argentina
OBJECTIVE:
Pharmaceutical markets are
characterized by a high degree of product
differentiation, where price, consumers’ income,
perceived quality, and reputation interact. In
addition, induced demand affects not only the
impact of prices on the decision of buying a drug,
but also the criteria used to prescribe it. In the
Argentinean case, without patent protection, there
is not a clear distinction between brand product
and generics, which in turn affects the nature of
competition. Marketing efforts targeting
physicians (detail advertisement) consume
important shares of pharmaceutical producers’
budgets. On the other hand, technical progress in
chemical ingredients provides consumers and
physicians with new alternatives of choice. The
goal of this paper is to understand the sources of
differentiation among products in four Argentinean
therapeutic classes, and their effects on price
elasticities. METHODS:
A discrete choice model of
product differentiation is used to measure demands
for antidiabetics, gastroprocinetics, prostatics
and quinolons, during 1988- 1995. Such demand
functions start with an individual utility
function, which is explained by observed prices,
product characteristics, and consumers’ tastes.
The econometric implementation takes the form of a
nested logit model, where the first source of
substitution is by chemical ingredient, followed
by variables related to marketing/reputation.
RESULTS:
The confirmed hypothesis is that
reputation builder variables are consistently
significant across therapeutic classes.
CONLUSIONS:
In addition, the study shows a
correspondence between the level of necessity of
the drugs and the relative importance of chemical
ingredients in the decision of consumption.
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PHP2 |
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COMPARATIVE ANALYSIS OF
ADVERTISING EFFECTIVENESS BETWEEN NEW AND EARLIER
ENTRANTS IN THE PHARMACEUTICAL MARKET
Kwong WJ, University of Georgia, College of
Pharmacy, Athens, GA, USA
OBJECTIVE:
To evaluate the presence of first-mover
advantage for pharmaceutical advertising that
would support the entry deterrence theory in the
pharmaceutical market. METHODS:
Advertising
elasticities of demand for pharmaceutical products
in the periods following new product entries were
estimated using time and disease fixed effects
estimation. One-period and two-period lag models
were estimated. Logarithm of a product’s sales
revenue was regressed on its own advertising
expenditure, total advertising expenditure of
competing products in the same market, number of
competing products, number of years the product
has been on market, a dummy variable indicating
whether the product is a new entrant, and an
interaction term between the dummy variable and
the product’s own advertising expenditure.
Scott-Levin Market Research Audit advertising
expenditure and product sales data from Jan 1995
to Dec 2001 were used were analyzed on a quarterly
basis. Products from eight therapy markets were
examined: asthma, migraine, obesity, Parkinson’s
disease, seizure, depression, lipid disorder, and
gastric and duodenal ulcer. RESULTS:
In both lag
models, product sales significantly increased with
a product’s own advertising expenditure, and
significantly decreased with the total advertising
expenditure of competing products, and the number
of competing products. For existing products,
advertising elasticity of demand was estimated to
be 0.068% in the one-period lag model and 0.062%
in the two-period lag model. Elasticity estimates
for new entrants was lower at 0.046% and 0.044%,
respectively. The elasticity estimates between new
and existing products were not significantly
different. Comparing results of the two lag
models, advertising elasticity of demand
depreciated at 8.7% per quarter. CONLUSIONS:
Results did not find any significant first-mover
advantage in the effectiveness of advertising
between earlier and later entrants that would
support the potential entry deterrence effect of
advertising in the pharmaceutical market. These
results did not support regulating pharmaceutical
advertising based on anti-competitive grounds.
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PHP3 |
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STUDY ON PHARMACEUTICAL
SETTING IN COMMUNITY HEALTH SERVICE
Cheng X, Fudan University, Shanghai, Shanghai,
China According to the results
of cluster analysis of pharmaceutical setting of
community health service, this study reveals
whether it can meet the curative needs on the
basis of the current condition of common diseases,
frequently occurring diseases and chronic
diseases. The study also analyzes its effects on
drug expenditure according to different scale of
pharmaceutical setting. Results of anova analysis
demonstrate that the scale of pharmaceutical
setting of community health service has an impact
on drug expenditure to some extent. The drug
expenditure per capita in the community health
service group which has 200 kinds of drugs or
above is higher than the group which has 100 to
200 kinds of drugs .However ,the difference
between the group which has 100 to 200 kinds of
drugs and the group which has less than 100 kinds
of drugs is not significant.
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PHP4 |
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IDENTIFY GAPS OF EVALUATION
OF ESSENTIAL MEDICINES IN CHINA
Sun X, Li Y, The Chinese Cochrane Centre,
West China Hospital, Sichuan University, Chengdu,
Sichuan, China
OBJECTIVE:
In 2002, an
evidence-based approach was initially applied to
evaluate essential medicines (EM) in China.
Although the performance of such an attempt was
recognized, the evaluation system was considered
incomplete. A study was, therefore, designed to
identify the gaps. METHODS:
The decision-makers
and reviewers who were involved in the evaluation
of EM in 2002 were convened. They were asked to
answer a list of wellconstructed questions, and
identify any additionally conceptualized problems
throughout the process. In addition, a literature
review was carried out, based on electronic search
of Pubmed (1980-2004), WHO website, Australian
Pharmaceutical Benefit Scheme website. RESULTS:
Several key weak points of the evaluation was
identified and recognized. A) Incomplete technical
contents: medicines were assessed eligibility
based on effectiveness and safety, and marketing
prices. The drug utilization and economic
feasibility were not estimated. B) Inadequate
evaluation METHODS:
the techniques to assess the
effectiveness and safety were either outdated
(e.g. quality appraisal by Jadad scale),
incomplete (e.g. assessment of safety based on
review of clinical trials) or inadequate (e.g.
marketing prices considered, instead of costs and
cost-effectiveness). C) Lack of efforts from
related professionals: reviewers mostly consisted
of medical specialists, pharmacologists and
pharmacists. No efforts from pharmacoeconomists,
pharmacoepidemiologists, and consumer and
industrial representatives were contributed. D)
Lack of outcome predicting and monitoring
mechanism: no established outcome research methods
were available, which might lead to unawareness of
results of drug utilization. E) Lack of
unpublished data: all the resources for evaluation
came from published data, whereas unpublished
data, as understood by pharmaceutical industry,
were not available. This resulted in bias of
selection of EM. F) Quality of evidence: the
evidence, especially of traditional Chinese
medicine, is too poor to be indicative for
decision-making. CONLUSIONS:
The evidence-based
evaluation of essential medicines in China is
still at its early stage.
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PHP5 |
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THE EFFECT OF DRUG POLICY ON
THE ADOPTION RATES OF NEW DRUGS IN KOREAN
OUTPATIENTS CARE
Choi SE, Kim JH, Health Insurance Review
Agency, Seoul, South Korea
OBJECTIVE:
Korea has implemented the new
prescription drug policy in 2000, which separated
the function of prescribing and dispensing drugs
between doctors and pharmacists and purposed to
improve the quality of drug use and remove the
economic incentive from doctor’s prescribing
behavior. The aim of this study was to understand
the adoption rates of new drugs in outpatient care
after the new policy, and explore the effect of
the policy on the adoption rates. METHODS:
Four
new prescription drugs frequently prescribed in
ambulatory care were selected. From 1999–2002, the
National Health Insurance (NHI) claims data for
prescription drugs of selected clinics was used.
The dependent variable was the adoption rate
defined by the period from the enlisted date of
the new drug on the NHI reimbursement list to the
first prescribed date by each clinic. The
explanatory variables were collected from the
adopter, technology, and environment
characteristics including policy change. The
claims data was merged with telephone survey data.
Cox’s proportional hazard regression was performed
to set and test the model in explaining the
factors influencing on the adoption rate. RESULTS:
The 1,792 observations were inputted into the
model. The model showed that the new prescribing
system made the adoption rate faster than before
the change (HR=295.7, p<0.001) but the
reimbursement restriction policy restricted the
adoption rate of new drugs (hazard ratio (HR) =
0.03, p<0.001). The behavioral characteristics
also influenced on the rate of adoption. Doctors
who prescribe more number of drugs per claims and
have higher proportion of drug costs per total
medical costs were early adopters (hazard ratio
1.02, p<0.05). In addition, the innovative drugs
and the drugs by multinational manufacturers were
adopted earlier. CONLUSIONS:
The prescribing
system change accelerated the new drugs to be
adopted earlier, but the reimbursement restriction
policy trade off this tendency. |
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PHP7 |
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ECONOMIC EVALUATION OF
DISEASE MANAGEMENT PROGRAMS
Suh R, Uniformed Services University of the
Health Sciences, Vienna, VA, USA
OBJECTIVE:
To review existing methodologies for
the economic evaluation of disease management (DM)
programs and to identify issues and challenges
facing purchasers, providers, vendors, and
patients as this field continues to evolve.
METHODS:
A literature review of current industry
standards for the economic evaluation of DM
programs, to include those proposed by
academicians, health plans, DM vendors, trade
groups and associations, and actuaries;
identification of common themes and unresolved
controversies; and suggestions for next steps and
further research. RESULTS:
A comparison of the 7
most recent and cited publications that provide
methodological recommendations for the economic
evaluation of disease management programs reveal
many common elements, as well as disparate
approaches to dealing with known challenges and
biases. Central to the differences is the need to
balance practical feasibility and methodological
rigor. This review identifies the key issues and
considerations that remain in formulating a true
industry standard for the economic evaluation of
disease management programs. CONLUSIONS:
Medicare’s new disease management pilot program
and the Congressional Budget Office’s findings of
“insufficient evidence” for the economic benefits
of DM programs have both spurred on greater
interest in finding valid methodologies that may
be used to substantiate claims of overall cost
savings and in establishing some comparability
across economic evaluation studies. While some
controversies remain, many organizations and
individuals have put forth several proposed
methodologies that seem appropriate for their
target populations. Moving toward consensus in
this field will need to accommodate the interests
and needs of a variety of stakeholders involved in
the disease management industry, and there may be
a role for federal research or regulatory bodies
in helping establish an industry-wide standard.
Further developments in this field may have
wideranging impacts as disease management
continues to grow in health systems outside the
United States.
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PHP9 |
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DELIVERY OF DAILY DOSES OF
THE DRUGS TO HOSPITAL DEPARTMENTS AS A METHOD OF
DRUG RATIONALIZATION AT THE CLINICS IN UNIVERSITY
TEACHING CENTRE NOVI SAD
Sabo A, Tomic Z, Faculty of Medicine, Novi
Sad, Serbia and Montenegro
OBJECTIVE:
Introducing daily instead of weekly
delivery of drugs and medicinal supply to hospital
departments has been widely supported by Ministry
of Health and Crown agency as a method for
improvement of quality of drug supply and
pharmacoekonomics in this field. According to
published data the pharmacoeconomic consequences
of this measurements could lower the drug and
medicinal supply expenses for as much as 90%. In
NoviSad Clinics, Serbia and Montenegro, weekly
delivery of drugs and medicinal supply is stil
present. Therefore, we performed a study in order
to see if a change to daily dosing, together with
everyday control of structure and dose of
prescribed drugs by clinical pharmacologist can
rationalize dug use. METHODS:
Our study with daily
dosing of drugs and medicinal supply started at
Urological clinic, University Teaching Hospital
Novi Sad, Serbia and Montenegro. At the beginning
the monthly use of drugs was followed up. The drug
use was calculated using ATC/DDD classification.
RESULTS:
According to our expectation, financial
results did show substantial lowering of the drug
expenses, of 36%, with antibacterilas being the
most restricted drugs, followed by local
anesthetics. CONLUSIONS:
The new way of drug
delivery, with every day follow up and corrections
of the structure and amount of drugs prescribed by
urologist significantly improved the safety and
quality of the drugs. Constant monitoring in drug
delivery enabled them to prevent potential
clinically harmful interactions, to improve
patients compliance together with substantial
financial results, that support the new system of
drug delivery.
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PHP10 |
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DEMAND NEEDS AND SUBSIDIES IN
PHARMACEUTICALS: THE EXPERIENCE OF THE REMEDIAR
PROGRAM IN ARGENTINA
Maceira DA, Apella IR, Barbieri E, Center
for the Study of the State and Society (CEDES),
Ciudad Autonoma de Buenos Aires, Buenos Aires,
Argentina
OBJECTIVE:
Between 2001 and
2002, as a consequence of the Argentinean economic
crisis, the existent gap between potential and
effective demand for pharmaceutical products
increased, especially in low income households. As
a result, the Ministry of Health launched the
Remediar Program, consisting in the public
provision of medicines among houses under the
poverty line and without formal health coverage.
By implementing a subsidy for pharmaceutical
products, families can substitute their own
purchases by free medicaments, shifting their
incomes to alternative uses. Considering that
Remediar acts as an indirectly subsidy for the
demand of medicines through primary health care
posts (CAPS), the main propose is to know the
ability of the Program to reduce the gap between
potential and effective demands under the poverty
line, as well as its effects over welfare in terms
of generated savings. METHODS:
By using two
Household Surveys on Expenses and Utilization at
the CAPS level during 2003 and 2004, designed for
this research, the paper develops a probit model,
estimating the probability of accessing to free
prescriptions, as a function of household incomes
and socioeconomic characteristics, formal health
insurance coverage levels, and the participation
of each CAP into the Program. The results were
compared to the data provided by the National
Household Survey of Expenses and Utilization in
Health developed by the Ministry of Health in
2003. RESULTS:
Estimations suggest a potential
redistributive effect due to the Program, by
improving equity on expenditures on
pharmaceuticals, which may imply a reduction of
the Gini coefficient from 0.11 to 0.08. In
addition, population under the first and second
income quintile might reach saving of their
expenses in drugs of 22.5 and 6.7 percent,
respectively. CONLUSIONS:
The paper shows the
effectiveness of the Remediar in increasing the
access to medicines of patients at the lowest
income quintiles.
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PHP11 |
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DETERMINANTS OF CATASTROPHIC
EXPENDITURE AND IMPOVERISHMENT OF HOUSEHOLDS IN
THAILAND
Prakongsai P1, Tangcharoensathien V2,
Limwattananon S3, 1International Health Policy
Program, Amphoe Muang, Thailand, 2International
Health Policy Program, Nonthaburi, Thailand, 3Khon
Kaen University, Amphoe Muang, Khon Kaen, Thailand
OBJECTIVE:
To explain variations in the magnitude
of health care catastrophe and household
impoverishment from out-of-pocket (OOP) payments
in relation to differences in services and
providers of health care during the pre- and post-
universal health care coverage (UC) periods in
Thailand. METHODS:
Analysis of the national
socio-economic surveys of household income and
consumption in 2000 (N=24,747), 2002 (N=34,785)
and 2004 (N=34,843). RESULTS:
Households whose
members being admitted to hospitals for inpatient
(IP) experienced health care expenditure beyond a
catastrophic level (defined as OOP payments more
than 10% of total consumption) most frequently
(31.0% during pre- UC period in 2000 and
15.1-14.6% during post-UC period in 2002-2004).
The catastrophic incidence in households with OOP
payments for out-patient (OP) without IP services
was less frequent (12.0% pre-UC and 7.9-8.3% post-UC).
The households paying OOP only for self medication
faced the catastrophic expenditure by only 2.1%
and 0.4-0.6% over the same period. Among the
households at risk to health care catastrophe from
IP service during the post-UC period, the
catastrophic incidence varied from 32.1-27.8% for
services by private hospitals, and 13.9-11.1% by
provincial hospitals and 6.5-7.3% by district
hospitals respectively. The variations in
household impoverishment due to OOP health
payments followed a similar catastrophic pattern.
Paying for IP services accounted for the poverty
increase by 95.6% and 84.0-71.5% of the
impoverished households during pre-UC and post-UC
periods, respectively. The relative increase in
post-OOP impoverishment was found in 98.8-100% of
those became poor from the payments to private
hospitals regardless of type of health care
services. CONLUSIONS:
Households making OOP
payments for IP services and private hospitals
were most likely to face the catastrophic health
care expenditure and impoverishment.
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PHP12 |
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EXPLORING THE AVAILABILITY &
CHARACTERISTICS OF HEALTH CARE COST DATA ACROSS
SELECTED ASIAN COUNTRIES
Bindra S1, Duttagupta S2, Chan BS3, Hongxia
C4, Cheah SK5, Wei Y4, Zhong J4, Sze-Man Lai J6,
Somasundaram S7, Suvarna V7, Nawawi S8, Lee HJ9,
Park HJ9, Nawaz A10, Tranquilino F11, Martin N11,
Ramachandran S12, Kulasingham S13, Lam KM14, Li
M15, Lin S15, Chu C16, Ponprasit K17, Nganthavee
W17, Pramanik A18, 1Pfizer Asia Regional Office,
Hong Kong, Hong Kong, 2Pfizer Inc, New York, NY,
USA, 3The Chinese University of Hong Kong, Hong
Kong, China, 4Pfizer China, Beijing, China,
5Pfizer Singapore, Singapore, Singapore, 6Pfizer
Hong Kong, North Point, Hong Kong, 7Pfizer India,
Jogeshwari, Mumbai, India, 8Pfizer Indonesia,
Jakarta, Indonesia, 9Pfizer Korea, Seoul, South
Korea, 10Pfizer Pakistan, West Wharf, Karachi,
Pakistan, 11Pfizer Phillipines, Makati City,
Philippines, 12Pfizer, Selangor, Malaysia,
13Pfizer Malaysia, Selangur Darul, Malaysia,
14Pfizer Singapore, Gateway East, Singapore,
15Pfizer Taiwan, Tamsui, Taiwan, China, 16Pfizer
Taiwan, Tamsui, China, 17Pfizer Thailand, Bangkok,
Thailand, 18Pfizer Asia, Admiralty, Hong Kong
OBJECTIVE:
Increasingly local and regional health
care payers are requesting economic analyses for
new drugs in order to effectively allocate
resources in various Asia-Pacific countries.
However, the availability of uniform and reliable
local or regional data sources necessary to
conduct such analyses is limited. In an effort to
better understand the availability and
characteristics of the health economic data
sources from selected countries in this region,
the following exercise was conducted. We
collaborated with various institutions across
selected Asian markets to gather relevant data to
identify opportunities for economic analyses
reflecting local and/or regional health care
practices. METHODS:
A list of commonly used health
care services associated with hospitalized
patients was developed from published literature.
Health care institutions were approached to
provide corresponding unit cost data, while
keeping within respective country-specific privacy
regulations. In addition, wherever available,
costs from published sources were also collected.
RESULTS:
Indicative of the social, cultural and
economic diversity of the region, health care
service costs varied considerably across the
selected countries. Cost for a comparable hospital
bed/day in a private ward varied from as little as
US$32 in Indonesia to US$72 in Pakistan.
Significant differences were also seen in the cost
per bed/day in a comparable ICU setting, ranging
from as little US$271 in Singapore to US$1800 in
Hong Kong Significant variances were also observed
for cost data collected on a number of comparable
inpatient and outpatient services. CONLUSIONS:
While progress is being made to develop
pharmacoeconomic analyses specific to health care
demand in the Asia-Pacific region, the quantity
and quality of available data to meet these
demands are still very limited.
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PHP14 |
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EFFECTS OF USING AN AUTOMATED
PRESCRIPTION FILLING SYSTEM ON PHARMACY STAFF
UTILIZATION AND PRESRIPTION FILLING LABOR
Lin AC1, Huang YC1, Punches G2, Chen Y1,
Qian JJ1, 1University of Cincinnati, Cincinnati,
OH, USA, 2Punches Pharmacy Plus, Michigan, MI, USA
OBJECTIVE:
To evaluate the
effects of using an automated prescription filling
system, ScriptPro 2000, on pharmacy staff
utilization and prescription filling labor in an
independent US pharmacy. METHODS:
Self-controlled
before and after the installation of the
automation. Pharmacy Setting: The Punches Pharmacy
Plus, an independent pharmacy located in Clare,
Michigan, USA and with a daily workload of 360
prescriptions was selected as the study site in
this study. Intervention: The installation of an
automated prescription filling system, ScriptPro
200. Data Collections: Videotaping and work
measurement techniques were used in collecting the
data of before and after installation of the
ScriptPro 200. Study Variables: The utilization of
the pharmacy staff (pharmacists and technicians)
and the labor utilized in direct and indirect
prescription-filling activities, e.g., receiving
order, order entry, filling, inspecting, packaging
and dispensing, phone calls, inventory management,
were measured and compared before and after the
installation. RESULTS:
With the installation of
automation, the pharmacy staff was significantly
reduced (?2=25.54, P<0.001) by 0.4 FTEs (Full Time
Equivalence) pharmacists’ efforts were shifted to
the technicians. Meanwhile, there was a
statistically significant difference in term of
the percentages of labor spent on various
activities between the pre-installation and
postinstallation of automation (?2=137.65,
P<0.001). Analyses of average labor used per
prescription showed that the installation of
automation could save 0.22 minutes per
prescription. Especially, for the counting labor
per prescription, it significantly decreased from
2.63 minutes to 2.07 minutes with an average of
0.56 minutes saved (Z=-1.984, P=0.045).
CONLUSIONS:
The automated system, ScriptPro 200,
has shown the usefulness in terms of reducing the
prescription filling labor. Further research
efforts should continue to assess other effects in
the workload, patient counseling and medication
errors and conduct the economic evaluation.
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PHP15 |
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IMPACT OF PHARMACIST’S
INTERVENTIONS ON COST OF DRUG THERAPY IN INTENSIVE
CARE UNIT
Saokaew S1, Maphanta S2, Thangsomboon P3,
1Naresuan University, Muang, Phayao, Thailand,
2Naresuan University, Muang, Phitsanulok,
Thailand, 3Buddhachinaraj Hospital, Muang,
Phitsanulok, Thailand
OBJECTIVE:
To determine pharmacist’s interventions
led to change in overall drug cost and to describe
the characteristics of pharmacist’s interventions
in a Thai intensive care unit. METHODS:
A
Prospective, standard care-controlled study design
was used to compare overall drug costs of patients
receiving care form patient care team including a
clinical pharmacist with standard care (no
pharmacist on team). All Patients admitted to the
medical intensive care unit (ICU) 1 and 2 during
the same period were included in the study. The
outcome measures were overall drug cost and length
of ICU stay. Interventions made by the pharmacist
in the study group were documented. The analyses
of rate of acceptance and cost saving and/or cost
avoidance were also performed. RESULTS:
A total of
65 patients were admitted to either ICU 1 or 2
during the 5 week- study period. The pharmacist
participated in patient care and made total of 127
interventions for the ICU-1 team. Ninety-eight
percent of the interventions were accepted by
physicians. The difference of overall drug cost
per patient between two groups was 6,982.05 THB
(41,298.5 THB in study group and 48,271.55 THB in
control group, p = 0.138). The average length of
ICU stay for the intervention group and the
control group was not significantly different
(7.16 days VS 6.18 days, p=0.995). The 125
accepted interventions were evaluated for cost
saving and cost avoidance. Pharmacist’s
interventions yielded a total of 75,624 THB from
drug cost saving and 11,301 THB from adverse drug
event cost avoidance. The net cost saved and
avoided from pharmacist interventions was
86,925.81 THB. Interventions involving antibiotic
use accounted for the largest economic impact
(75,132.18 THB). CONLUSIONS:
Having a pharmacist
participated in ICU patient care team can reduced
overall drug cost, cost saving, and cost
avoidance. The largest economic impact involved
antibiotic use.
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PHP16 |
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BARRIERS TO PHARMACEUTICAL
CARE IN THAILAND
Ngorsuraches S1, Li SC2, 1Prince of Songkla
University, Hatyai, Songkla, Thailand, 2National
University of Singapore, Singapore
OBJECTIVE:
To examine barriers to pharmaceutical
care in Thailand. METHODS:
The study had a
cross-sectional and descriptive design. Data were
obtained from a survey of a random sample of 600
hospital and community pharmacists across the
country. The survey was developed to measure
barriers to the provision of pharmaceutical care
from the hospital and community pharmacists’
perception using 5-point Likert scales (1 =
‘strongly disagree’ to 5 = ‘strongly agree’).
Descriptive statistics were used for data
analyses. RESULTS:
The response rate was 53.2%;
with hospital pharmacists comprised 78.4% of all
respondents. The majority of respondents had one
to five years in patient care pharmacy practice.
The Cronbach alpha of study measure for the
pharmacists’ perception of barriers to
pharmaceutical care was 0.83. The pharmacists
agreed that lack of data on the proven value of
providing pharmaceutical care, lack of therapeutic
knowledge and clinical problem-solving skills, and
lack of role model who provides pharmaceutical
care deterred them from providing pharmaceutical
care. On the other hand, lack of opportunities for
face-to-face encounters with patients, lack of
patient demand and acceptance of pharmaceutical
care, and other health care providers’ resistance
did not greatly prevent them from providing
pharmaceutical care. CONLUSIONS:
Even though
pharmaceutical care has been adopted to pharmacy
practice and documented to prevent drug-related
problems in Thailand for a number of years, the
pharmacists still perceived that insufficient
evidence supporting the value of providing
pharmaceutical care existed. To remove the
barriers, besides an increase in therapeutic
knowledge, and clinical skills, more evidence of
the proven value of providing pharmaceutical care
and role models for pharmaceutical care are also
needed.
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PHP18 |
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SURVEY STUDY OF
PHARMACOECONOMIC RESEARCH IN THE PACIFIC ASIA
REGION
Luo MP, Cifaldi M, Abbott Laboratories,
Abbott Park, IL, USA
OBJECTIVE:
Given the rapid
economic growth and increasing rate of health care
spending in the Pacific Asia (PA) area,
pharmacoeconomic research (PE) has the potential
to assist decision-making on pharmaceutical
coverage. This study evaluated the environment and
the future trend for PE in the PA region. METHODS:
A comprehensive survey of pricing and
reimbursement personnel from pharmaceutical
industry was conducted in 15 countries in the PA
area in 2004. The survey consisted of 22
structured questions and covered the following
issues: health care system, PE guidelines, factors
impacting pricing and reimbursement decision,
importance of PE data in supporting reimbursement,
submission channel for PE data and future
expectations. The questionnaire was pretested for
content validity. Respondents were expected to
answer the survey relying on their own local
knowledge and experience. RESULTS:
The response
rate on the survey was 87% (13 out of 15
countries). In most countries reimbursement
mechanisms were reported as combination of
government funding and private insurance. Over 60%
of the countries had a reimbursement list for
prescription drugs. Most countries indicated that
drug price was determined based on reference
pricing, parity pricing and pharmaceutical
profitability, while reimbursement decision was
primarily based on drug price, but clinical data
and pharmaceutical data also had a role. At the
time of the survey, one-fifth of the countries
indicated that PE data were required for
reimbursement and additional one-half of the
countries indicated that PE data were helpful.
Three-fourth of the surveyed countries expected
that PE data would be required for pricing and
reimbursement within 5 years. CONLUSIONS:
Although there were variations with regard to the
practice and potential for PE data among the
surveyed PA countries, this study suggested that
PE is emerging in the PA region and more countries
are moving toward some formal requirement for PE
evidence for pharmaceuticals.
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PHP19 |
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ANALYSIS OF PHARMACEUTICAL
PRICE CHANGES IN A REGIONAL HOSPITAL SYSTEM
Kelton CM1, Guo JJ1, Rebelein RP2, Ferrand
Y1, Dusing ML3, 1University of Cincinnati,
Cincinnati, OH, USA, 2Vassar College,
Poughkeepsie, NY, USA, 3Health Alliance,
Cincinnati, OH, USA OBJECTIVE:
Drug expenditures have been rising rapidly in the
United States over the past decade, with annual
double-digit increases, due partly to rising
utilization and partly to rising prices. Hospital
expenditures on pharmaceuticals rose 11 percent
between 2000 and 2001, with considerable variation
across individual drug purchases. Our objectives
are (1) to identify drugs with extreme transaction
price changes and (2) to determine whether large
swings are associated with particular
manufacturers and/or therapeutic classes. METHODS:
Monthly expenditure and utilization data are
collected for the 2000 and 2001 calendar years for
a large, six-hospital system for all regularly
purchased drug products. Monthly transaction
prices are derived from these data, and annual
price changes are calculated from average annual
transaction prices for the two years, for
approximately 3000 drug products. RESULTS:
185
drugs had price swings of at least 20 percent. The
largest price increases were for fentanyl citrate
and albuterol with annual rises of 368 percent and
273 percent, respectively. There were 13 drugs
with price increases of 100+ percent. The hospital
buyer experienced the largest number of high price
increases in the adrenal, penicillin, and
antiretroviral-agent therapeutic classes, while
the companies responsible for the highest number
of price increases were Pharmacia & Upjohn,
GlaxoSmithKline, Mead Johnson & Company, and UDL
Laboratories. A regression of price change on
company and class dummy variables reveals that
only seven percent of the variation in price
change can be explained by company or class
affiliation. CONLUSIONS:
Price changes for
individual drugs can be quite substantial even
over a single year. Though there is significant
variation in individual drug price change (from
-80 percent to over 300 percent), very little of
this variation can be explained by manufacturer or
therapeutic class. Drug-specific factors such as
patent expiration or production issues must
explain most of it.
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PHP20 |
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ANALYSIS OF THE PRESCRIPTIONS
FILLING LABOR IN A MAJOR US DRUGSTORE CHAIN
Lin AC, Qian JJ, Chen Y, University of
Cincinnati, Cincinnati, OH, USA
OBJECTIVE:
This study was designed to quantify the
staffing utilization, in terms of the time spent
by pharmacy staff on various activities, and the
direct and indirect prescription filling time, in
an US chain drugstore. METHODS:
Eight pharmacy
sites of a major US drugstore chain. Data
Collections: Videotaping and work measurement
techniques were used to collect the data from each
selected pharmacy. Each pharmacy was observed by
strategically installed cameras for seven days
including five weekdays and two weekends. One
minute fixed interval work sampling approach was
applied for reviewing the videotapes. Study
Variables: The utilization of the pharmacy staff
and the time spent in direct and indirect
prescription-filling activities, such as:
receiving, order entry, filling, inspecting,
packaging and dispensing phone calls, inventory
management, were measured and compared through the
work sampling process. RESULTS:
Totally, 166,703
minutes during 56-day study period at eight sites
were observed, among which 1,087.9 hours (65,276
minutes) for the pharmacists and the other 1,609.5
hours (101,427 minutes) for technicians. The
results indicated an overall of 10.02 minutes
(including 7.88 minutes for direct filling
activities and 2.15 minutes for indirect filling
activities) were spent by each prescription. The
ratio of pharmacist verse technician in direct
filling time is 1:1.52, but 1:1.65 in indirect
filling time. CONLUSIONS:
This study illustrated
the time spent on various activities related to
prescription filling by the pharmacy staff in an
US drugstores chain and provides the micro-view of
labor consumed for each prescription filling. This
study enables the managers of pharmacy to utilize
the pharmacy staff with optimal staffing
arrangements. Further efforts should be put into
the study of potential factors affecting the
efficiency of pharmacy.
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PHP21 |
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THE EFFECTS OF AUTOMATED
PRESCRIPTION FILLING SYSTEM ON THE INVOLVEMENT OF
PHARMACY STAFF IN PRESCRIPTION FILLING ACTIVITIES
Lin AC, Huang S, Qian JJ, Chen Y, Ma XQ,
University of Cincinnati, Cincinnati, OH, USA
OBJECTIVE:
This study was to examine if the use of
an automated prescription filling system would
affect the pharmacy staff involvement in
prescription filling activities in a major US
chain drugstore. METHODS:
Eight pharmacy sites
were selected from one major US drugstore chain.
Data Collections: Videotaping, work measurement,
and telephone recording techniques were used for
data collection. Cameras were strategically
installed, collecting data for a continuous seven
days in each sample site. One minute fixed
interval work sampling approach was applied in
reviewing the videotapes. Study Variables: The
time spent in non-judgmental prescription filling
activities by pharmacy staff, including drop off,
order entry, filling packing, and storing by
pharmacists and technicians were also observed.
Data Analysis: Mann-Whitney test was applied and
all the statistical analyses were performed using
the software SPSS. RESULTS:
Among the eight
selected pharmacies, three pharmacies were
equipped with Pharmacy 2000 and Baker Cell and
five did not have automation technologies. The
time spent by pharmacists on non-judgmental
activities per prescription in pharmacies with and
without automation was 1.33 ± 0.99 and 2.06 ± 0.50
minutes, respectively (Z=-1.043, P=0.297). The
time spent by technicians was 4.14 ± 1.11 and 2.78
± 0.33 minutes (Z=-1.64, P=0.101). The ratio of
time spent on non-judgmental activities by
pharmacists and technicians in the pharmacies with
and without automation were 1:3.11 and 1:1.35,
respectively. Moreover, there was an average of
0.12 minutes spent by pharmacists on patient
counseling per prescription in pharmacies with
automation, which was about twelve times more than
pharmacies without automation. CONLUSIONS:
It
indicates: 1) more non-judgmental prescription
filling activities were performed by technicians
due to the working shift by the automation, and 2)
pharmacy staffs increase direct contacts with
customers at the pharmacies featuring an automatic
prescription filling system.
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PHP22 |
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THE EFFECTS OF TELEPHONE
CALLS ON PRESCRIPTION FILLING EFFICIENCY IN A
DRUGSTORE CHAIN
Lin AC, Waston W, Chen Y, Qian JJ,
University of Cincinnati, Cincinnati, OH, USA
OBJECTIVE:
This study was to quantify the
occurrence of telephone calls, and to examine the
effects of those telephone calls on prescription
filling efficiency in a major US drugstore chain.
METHODS:
Four pharmacies (A, B, C, and D) of one
major US chain drugstore were selected for this
study. Data Collections: Videotaping, work
measurement, and telephone recording and reviewing
techniques were used. Telephone calls were
automatically captured and digitalized by the
computer system. Study Variables: The study
variables include the number of prescriptions
filled per hour, direct prescription filling time
(DRxFT), and daily frequency of phone call. Data
Analysis: Each phone call was reviewed and
categorized. One minute fixed interval work
sampling approach was applied for reviewing the
videotapes. RESULTS:
The daily frequency of phone
calls in pharmacies, A, B, C, and D were
230.14±77.81, 116.14±66.46, 160.86±136.26, and
309.43±157.48, respectively (F=3.706, P=0.025).
The corresponding estimated number of
prescriptions filled per hour and DRxFT were
5.94±1.21 and 7.01±1.73 for pharmacy A, 6.93±3.62
and 6.48±1.95 for pharmacy B, 6.48±1.37 and
7.07±1.50 for pharmacy C, 5.25±1.29 and 8.52±1.79
for pharmacy D, respectively. It was found the
more daily phone calls the pharmacy had, the less
number of prescriptions were filled per hour,
thus, taking longer to fill one prescription;
however, the correlation between frequency of
daily phone calls and number of prescriptions
filled per hour were not found to be statistically
significant (r=-0.052, P=0.793), as well as the
correlation between the daily frequency of phone
calls and DRxFT (r=0.183, P=0.352). CONLUSIONS:
Although the findings were not statistically
significance, a positive correlation was found
between the DRxFT and daily frequency of phone
calls. More frequent phone calls were associated
with longer DRxFT and lower hourly prescription
throughput rate. Reducing the frequency of
incoming daily phone calls could improve the
efficiency of pharmacy operation.
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PHP24 |
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DEVELOPING A QUANTITATIVE
SCORING SYSTEM FOR ADVERSE DRUG REACTION
ASSESSMENT USING GENETIC ALGORITHM
Koh Y, Yap CW, Li SC, National University
of Singapore, Singapore
OBJECTIVE:
To improve the scoring system of a
newly developed ADR algorithm to measure the
probability of ADR causality. METHOD: Several ADR
cases obtained from Pharmacoviligance Unit at
Ministry of Health with known causality
probability values were used as reference points
for the development of the scoring system. Based
on a review of ADR reports with definite causality
assessment, several rules were developed to define
all possible combinations of criteria for
‘Definite’ ADR cases and some combinations for
‘Probable’ ADR cases. These parameters were used
to determine the new scoring system with the help
of genetic algorithm. Testing of the new scoring
system was performed on 37 ‘Definite’ ADR cases.
In addition, sensitivity and specificity analysis
were performed to allow a comparison of
performance between our algorithm and the
algorithm used by ADRAC. RESULTS:
When this new
scoring system developed by using genetic
algorithm was applied to the 37 ‘Definite’ ADR
reports, 83.8% were identified as ‘Definite’
compared to 21.6% by guidelines from ADRAC. Our
new algorithm gave a sensitivity of 83.8% and
specificity of 71.0% (versus 21.6% and 98.4%
respectively for ADRAC). Hence, our algorithm had
more cases being classified correctly.
CONLUSIONS:
The refining of the scoring system to
reflect a quantitative scale has helped make this
algorithm more sensitive and increased its useful
index, especially when used by clinicians,
regulatory agencies or drug companies to generate
ADR alert signals. Using a quantitative method of
assessing causality also mean that rare ADRs and
new ADRs can be detected since a quantitative
score can give more precisely the degree of ADR
causality.
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PHP25 |
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MODULAR STUDY FOR MEDICAL
SUPPLIES IN SUDDEN PUBLIC HEALTH EVENTS
lulu Z1, Yuan L1, Guoquan R2, 1Second
Military Medical University, Shanghai, China,
2General Logistics, PLA, Beijing, China
OBJECTIVE:
Nowadays, how to prevent and handle
sudden public health events has become a popular
talk in public health administration. Medical
supplies in sudden public health events play a
more important role in the study of sudden public
health events handling. Fine medical supplies is
not only benefit to handle sudden public health
events quickly, but has good economic effect.
Based on this analysis, we put forward a
modularization method for medical supplies in
sudden public health events. METHODS:
We gathered
proceeding related material, and analysed the
characteristic of medicine demand and consumption
laws. We also studied disease composition of
different sudden public health events, severe
degree of disease and different parameters of
treatment for all kinds of diseases. In accordance
with the principle of modularization, adopting
system analysis and statistics methods, we
designed all kinds of basic modules and the
combination methods for these modules under every
sudden public health event. First, to divide
medical supplies into a certain number of basic
modules, then combine these basic modules into
different aggregates which compose the medical
supplies modules. RESULTS:
According to the
results of the data collection, we used
modularization method and cluster analysis to
ascertain the scope of atreatment of basic module.
On the basis of these studies, we formed the
standard of variety and quantity of basic modules.
Then we used modularization combination method to
complete the combination of basic modules under
different sudden public health events.
CONLUSIONS:
When sudden public health events
happen, we can work out a supply plan quickly
according to kind and severe degree ensuring the
timely handling of these events. Additionally,
modularization for medical supplies provides a new
method to medicine reserve of preventing sudden
public health events for us, which must be helpful
to save money and resources.
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PHP26 |
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HOW DO SURVEY RESPONDENTS
INTERPRET AND UTILIZE SYMBOLS USED IN HEALTH
VALUATION STUDIES?
Wee HL1, Li SC2, Zhang XH2, Xie F2, Luo N3,
Cheung YB4, Machin D5, Fong KY1, Thumboo J1,
1Singapore General Hospital,Singapore, 2National
University of Singapore, Singapore, Singapore,
3QualityMetric Inc, Lincoln, RI, USA, 4London
School of Hygiene & Tropical Medicine, London, UK,
5National Cancer Centre Singapore, Singapore
OBJECTIVE:
Symbols have been used in health
valuation studies to aid respondents in valuing
health states. As it is unclear if symbols are
culturally appropriate and useful in Asians, we
studied their usefulness in differentiating
various severity levels of a health state in a
multi-ethnic, urban Asian population. METHODS:
In
in-depth interviews with adult Chinese and Indian
Singaporeans (selected to represent various ages/
educational levels) conducted in English, Chinese
or Tamil, respondents were shown a health state
with 6 levels (HUI3 vision), each linked with a
symbol, with increasing severity implied by
increasing number of sides in each symbol.
Respondents were asked if symbols were: 1) useful
in differentiating severity of each level
(measured using both dichotomous and 0-10 VAS
scales); 2)offensive, and 3)to assess seven
alternative symbol sets. RESULTS:
Of 46 subjects
(54% Chinese, 54% female, median age: 42 years),
23 (50%) understood that symbols represented
various ranked health levels. However, only 11 of
46 subjects (24%) felt symbols were useful in
differentiating severity of each level. Reported
usefulness of symbols was low (median VAS score (IQR):
3.0 (0.0, 6.0), 12 (26%) subjects giving a score
above 5). No subject felt symbols were offensive.
When asked to assess alternative symbol sets, 14
(30%) respondents expressed no preference, 4 (9%)
preferred numbers and 28 (61%) preferred
alternative sets. Among these 28 subjects, squares
of increasing size were preferred by 35%, followed
by squares of the same size in different shades of
grey (26%). CONLUSIONS:
Although symbols were
culturally acceptable, less than one quarter of
Chinese in Indian subjects found them useful in
differentiating various severity levels,
suggesting that symbols are useful only for a
subgroup of subjects. Selection of the ideal
symbol set for use in health valuation would be
difficult, given the preference for a wide variety
of symbol sets.
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PHP27 |
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WHAT FACTORS INFLUENCE THE
RANKING OF IMPORTANCE OF HEALTH DOMAINS? AN
EXPLORATORY STUDY AMONG CHINESE AND INDIAN
SINGAPOREANS
Xie F1, Li SC1, Wee HL2, Zhang XH1, Luo N3,
Cheung YB4, Machin D5, Fong KY2, Thumboo J2,
1National University of Singapore, Singapore,
2Singapore General Hospital, Singapore,
3QualityMetric Inc, Lincoln, RI, USA, 4London
School of Hygiene & Tropical Medicine, London, UK,
5National Cancer Centre Singapore, Singapore
OBJECTIVE:
The relative importance of various
health domains may vary among individuals. We
sought to identify factors influencing the ranking
of health domains in a multi-ethnic, urban Asian
population. METHODS:
In in-depth interviews with
adult Chinese and Indian Singaporeans (selected to
represent various ages/educational levels)
conducted in English, Chinese or Tamil,
respondents were asked to rank EQ-5D domains
(mobility, selfcare, usual activities,
pain/discomfort, anxiety/depression) from most to
least important. Mann-Whitney U tests/Chi-square
tests and logistic regression models were used to
determine the influence of ethnicity, age, gender,
education, and presence of chronic medical
conditions on ranking for mobility or self-care as
the most important domain (as ² 5 respondents
ranked each of the remaining domains as most
important). RESULTS:
Of 46 respondents (54%
Chinese, 54% female, median age: 42 years), 20
(44%) respondents ranked mobility and 16 (35%)
ranked self-care as most important respectively.
Respondents ranking mobility as most important
were more likely to be older (49.1 vs 38.6 years,
p=0.008) or ethnic Indians (70% vs 30%, p=0.005).
Both variables were statistically significant in
the logistic regression model (OR=1.06,
95%CI=1.00-1.11, p=0.023, and OR=7.09,
95%CI=1.67-30.03, p=0.008, respectively).
Respondents ranking self-care as most important
were more likely to be younger (37.6 vs 46.4
years, p=0.027). This variable was close to
attaining statistical significance in the logistic
regression model (OR=0.96, 95%CI=0.91-1.00,
p=0.067). CONLUSIONS:
This exploratory study
suggests that ethnicity and age may influence the
ranking of important health domains in a
multiethnic urban Asian population in Singapore.
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PHP28 |
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THE IMPACT OF TALKING ABOUT
DEATH ON HEALTH STATE VALUATION: A STUDY AMONG
CHINESE AND INDIAN SINGAPOREANS
Wee HL1, Li SC2, Zhang XH2, Xie F2, Nan L3,
Cheung YB4, Machin D5, Fong KY1, Thumboo J1,
1Singapore General Hospital, Singapore, 2National
University of Singapore, Singapore, 3QualityMetric
Inc, Lincoln, RI, USA, 4London School of Hygiene &
Tropical Medicine, London, UK, 5National Cancer
Centre Singapore, Singapore
OBJECTIVE:
Cultural differences in willingness to
discuss death may influence participation rates,
accuracy of responses and cross-cultural
comparability in health valuation studies. We
therefore characterized perceptions and comfort in
discussing death in a multiethnic, urban Asian
population. METHODS:
In in-depth interviews with
adult Chinese and Indian Singaporeans (selected to
represent various ages/ educational levels)
conducted in English, Chinese or Tamil, subjects
rated their ease in discussing death (EID) using a
0-10 visual analogue scale (VAS). Subjects also
reported, using the same scale: 1) religiosity; 2)
acceptability of 8 descriptors for death (e.g.
passed away, sudden death, immediate death); and
3) preference for “pits” versus “all-worst”.
Finally, subjects valued 3 hypothetical health
states using 0-100 VAS followed by time trade-off
(TTO). The influences of various factors on EID
were compared using Mann-Whitney tests.
Correlations between EID and health utilities were
evaluated using Spearman rank correlation.
RESULTS:
Among 46 subjects (54% Chinese, 54%
female, median age: 42 years), median
self-reported religiosity was significantly lower
for Chinese (5.0 (0.0, 7.0)) compared to Indians
(7.0 (5.0, 10.0), p=0.004). Subjects were
generally comfortable in discussing death (median
(IQR): 8.0 (7.0 to 10.0)). Neither
sociodemographic factors nor religiosity
influenced subjects’ comfort level. In relation to
descriptors for death, both Chinese and Indian
subjects felt “passed away” (median (IQR): 8.0
(7.0, 10.0)) was more acceptable than “sudden
death” (5.0 (3.0, 7.0)) or “immediate death” (5.0
(2.0, 7.0)). Subjects clearly preferred
“all-worst” (median (IQR): 8.0 (6.0, 9.3)) to
“pits” (5.0 (0.8, 8.0)). Correlations between EID
and health utility score were generally weak
(range –0.263 to 0.386 (VAS) and –0.283 to 0.162 (TTO)).
CONLUSIONS:
Chinese and Indian Singaporeans were
generally comfortable in discussing death. The
poor correlation between EID and health utility
scores suggests that the latter are unlikely to be
influenced by willingness to discuss death.
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PHP29 |
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DOES RANKING OF HEALTH
DOMAINS INFLUENCE HEALTH UTILITIES? AN EXPLORATORY
STUDY AMONG CHINESE AND INDIAN SINGAPOREANS
Xie F1, Li SC1, Wee HL2, Zhang XH1, Luo N3,
Cheung YB4, Machin D5, Fong KY2, Thumboo J2,
1National University of Singapore, Singapore,
Singapore, 2Singapore General Hospital, Singapore,
Singapore, 3QualityMetric Inc, Lincoln, RI, USA,
4London School of Hygiene & Tropical Medicine,
London, United Kingdom, 5National Cancer Centre
Singapore, Singapore, Singapore
OBJECTIVE:
We hypothesized that an individual
would likely express a lower utility for a health
state (HS) in which the health domain that s/he
values is impaired, and explored this in a
multi-ethnic, urban Asian population. METHODS:
In
in-depth interviews with adult Chinese and Indian
Singaporeans conducted in English, Chinese or
Tamil, respondents were asked to; (i) sort and
rank 3 EQ-5D HS (A, B and C) on 0-100 visual
analogue scale (VAS), and (ii) rank 5 EQ-5D
domains from most to least important. Analysis was
performed for mobility and self-care domains as
few (²5) respondents ranked other domains as most
important. We hypothesized that among subjects
selecting 1)mobility: adjusted VAS scores would be
lowest for HS-B (greatest mobility impairment) and
highest for HS-A (least impairment); 2)self-care:
adjusted VAS scores would be lowest for HS-C
(greatest self-care impairment) and highest for
HS-A (least impairment). We performed separate
multiple linear regression (MLR) with VAS scores
as the dependent variable and importance ranking (IR)
as independent variables with adjustment for age,
ethnicity, education and presence of chronic
medical conditions. RESULTS:
Of 46 respondents
(54% Chinese, 54% female, median age: 42 years),
20 (44%) ranked mobility and 16 (35%) ranked
selfcare as most important respectively. MLR
coefficients (95% CI) for HS-A, -B and -C were:
0.8 (-11.5 to 13.1), -0.6 (-10.5, 9.3), -11.3
(-24.8 to 2.2) for mobility and 8.0 (-3.3 to
19.4), -5.5 (-14.7, 3.7), 7.1 (-5.9, 20.1) for
self-care, reaching clinical significance (of 5
points) in 4 instances but were not statistically
significant. In addition, the hypothesized trends
were not observed. CONLUSIONS:
In this
exploratory study, the influence of IR on utility
scores was at times clinically important, though
not statistically significant. This suggests that
IR may influence health utility scores, an
association which needs to be tested in larger
studies.
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PHP30 |
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THE VALUE PROPOSITION OF
OUTPATIENT TOWARDS OUTPATIENT SERVICE.
Sooksriwong CO, Mahidol University,
Bangkok, Thailand, Vijitmakthong A, King
Chulalongkorn Memorial Hospital, Bangkok, Thailand
OBJECTIVE:
The purpose of this study was to assess
the out-patient’s value proposition of outpatient
service by importance-performance rating
technique. The results are expected to help in
providing better services and increase patient
satisfaction. METHODS:
The civil servant patient
group, which contributed major hospital incomes
was selected to be the sample. The interviewing
questionnaire was used for data collection from
358 out-patients receiving outpatient service
during April and May 2004 at King Chulalongkorn
Memorial Hospital. The questionnaire included
important and performance assessment, general
information and factors affecting the patient’s
decision in selecting hospital. RESULTS:
Most of
the patients (64.5%) were female, 26.54% were
between 45-54 years old (average 44.88 years),
61.5% held Bachelor degree. Most of them spent 1-2
hours in traveling to hospital, but they were
mostly satisfied in travel time. 29.6% were new
patients who visited the OPD at the first time.
Among the old patient group, the average OPD visit
times were 3.44 times per year. The top three high
value and high performance areas, which were
hospital’s strong points, were “medical service by
physician”, “pharmacy service”, and “providing
service by gently and friendly officers”. Three
important services with high importance and low
performance level which the hospital should
concentrate on improving were “having guarantee
waiting time in each service center”, “adequate
car park”, and “clean and good hygiene restroom.”
Factors affecting their decisions were “modern
technology equipment”, “confidence in doctor and
officer ability” and “government hospital”.
Comparison of the value proposition between groups
of patients were provided. CONLUSIONS:
The
hospital should promote its strong areas and
improve its services rated as high importance and
low performance in order to increase the patients’
satisfaction.
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PHP31 |
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MEASUREMENT AND VALUATION OF
HEALTH STATUS EQ-5D WITH TIME TRADE-OFF IN SOUTH
KOREA
Jo MW1, Yun SC2, Hwang IA1, Lee SI1, 1University
of Ulsan College of Medicine, Seoul, South Korea,
2Asian Medical Center, Seoul, South Korea |
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