IMPLEMENTATION OF AN AUTOMATIC LABORATORY DATA CHECKING SYSTEM TO REDUCE DEDUCTION OF STATINS REIMBURSEMENT IN A TEACHING HOSPITAL IN TAIWAN

Author(s)

Lu T, Chang Y, Lin Y
Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

OBJECTIVES According to National Cholesterol Education Program Adult Treatment Panel IV, lipid-lowing agent is required if in patient with atherosclerotic risks. The annual cost of statins consumption was the first five human medications in Taiwan. Therefore, disallowed/deduction of reimbursement from Administration of National Health Insurance (NHI) was relatively higher than other drugs. An “Automatic Laboratory data Checking System” was established in order to enhance rational use of statins and to reduce deduction rate of statins reimbursement. This study aims to analyze the economic outcomes after implemented the system. METHODS The major cause of deduction was the lipid profile fragmented in the medical record. To ensure rational use of statins based on NHI regulation, an “Automatic Laboratory data Checking System” in computerized physician order entry (CPOE) system was implemented in a teaching hospital on February 2013. When processing a statin prescription through CPOE system, the prescriber should choose the lipid profile linked with laboratory system in our hospital, or filled in lipid profile performed at outside source. The prescription would be blocked if the inspection date and laboratory data were not adherence to the NHI regulation. RESULTS After system implementation, the deduction of statins reimbursement was significantly decreased. There were three indicators substantially improved in year 2013 than 2012: The average quarterly deduction was 2.16 million NTD reduced, the average quarterly deduction rate was 14% reduced (18.18% versus 3.95%), and the disallowed reimbursement account for 57.11% medication fee decreased to 7.17%. CONCLUSIONS The present study demonstrated that “Automatic Laboratory data Checking System” lessen the economic burden of statins reimbursement based on NHI regulations. The system was associated with rational use of statins and reducing disallowed reimbursement as well.

Conference/Value in Health Info

2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands

Value in Health, Vol. 17, No. 7 (November 2014)

Code

PCV160

Topic

Health Policy & Regulatory, Health Service Delivery & Process of Care

Topic Subcategory

Prescribing Behavior, Reimbursement & Access Policy

Disease

Cardiovascular Disorders

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