http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : Al-Zakwani, Ibrahim S (검색결과 2 건)
-
-
Al-Zakwani, Ibrahim S University of the Sciences in Philadelphia 2005 해외박사(DDOD)
Prescription cost-sharing mechanisms have been demonstrated to reduce prescription utilization and expenditures. However, the literature evaluating the impact of prescription cost-control on actual clinical outcomes is largely unexplored. The aim of this research was to evaluate the effect of higher prescription co-payments on clinical outcomes in patients with hypercholesterolemia in a managed care organization. A retrospective, observational cohort analysis was conducted of pharmacy, medical, and laboratory claims database from a southeastern US health plan. Patients were included if they began statin therapy between 7/1/1999 and 6/30/2001, had no dyslipidemic therapy in the previous 6 months, had continuous health plan enrollment 6 months pre-index and 12 months post-index, and had both pre- and post-index lipid measurements. Patients were stratified into higher (≥$20) and lower (<$20) prescription co-payment cohorts. The primary endpoints were mean percent change in each of the lipid fractions (total cholesterol [TC], LDL-cholesterol [LDL-C], HDL-cholesterol [HDL-C], and triglycerides [TG]), NCEP-ATP-III (National Cholesterol Education Program) LDL-C goal attainment, and time to development of major adverse cardiac event (MACE). Statistical analyses were conducted using ordinary least squares, logistic, and Cox proportional hazard regression. A total of 5,476 patients were identified (<$20 = 3,157; ≥$20 = 2,319). The higher prescription co-payment cohort was associated with a significantly greater adjusted mean percent reduction in LDL-C (-26.2% vs. -25.2%; p = 0.022) and a significantly greater adjusted mean percent increase in HDL-C (1.6% vs. 0.7%; p = 0.039) when compared to the lower prescription co-payment group. There were no significant differences in mean percent change in TC and TG as well as NCEP-ATP-III LDL-C goal attainment rates between the groups. However, patients in the higher prescription co-payment cohort were associated with higher MACE events compared to those in the lower prescription co-payment group (HR 1.37; 95% CI: 1.02 to 1.85; p = 0.36). These findings indicate an association between prescription cost-sharing and the most important outcome measure of all, actual cardiac events. However, the non-significant and counterintuitive findings of the intermediate lipid laboratory outcomes as well as the potential limitations, call for substantial further research into the relationship between prescription co-payment and MACE before any definitive conclusions are made.
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
