Featured Research

from universities, journals, and other organizations

Higher medication spending doesn't indicate better prescribing quality, study finds

Date:
November 4, 2010
Source:
University of Pittsburgh Schools of the Health Sciences
Summary:
Medicare patients in regions that spend the most on prescription medications are not necessarily getting better quality care, according to a new study of spending practices. The findings reveal great variation across the country in both drug spending and the rate of inappropriate prescriptions for the elderly.

Medicare patients in regions that spend the most on prescription medications are not necessarily getting better quality care, according to a new study of spending practices from the University of Pittsburgh Graduate School of Public Health (GSPH). The findings, published in the Nov. 3 Online First issue of the New England Journal of Medicine, reveal great variation across the country in both drug spending and the rate of inappropriate prescriptions for the elderly.

Lead investigator Yuting Zhang, Ph.D., assistant professor of health economics at GSPH, said that even after demographic characteristics such as age and sex, individual health status and insurance coverage are taken into account, it's clear that Medicare drug spending varies broadly among hospital-referral regions (HRRs).

"Higher spending can be justified if it's for drugs that are necessary and appropriate and improve patients' health," she said. "But if certain drugs are being incorrectly prescribed to seniors, then that can lead to complications and expensive interventions, such as hospitalization. As we try to reform health care to get costs under control, we need a better understanding of how spending differs regionally to make a positive impact."

Dr. Zhang and her colleagues assessed two measures of prescription quality from the Healthcare Effectiveness Data and Information Set (HEDIS). One measure indicates whether a Medicare beneficiary receives at least one high-risk drug, such as some antihistamines and muscle relaxants, that should be avoided in the elderly. The other assesses whether Medicare beneficiaries who have dementia, chronic kidney failure, or a history of pelvic or hip fractures are given prescriptions in the outpatient setting for drugs that shouldn't be given to patients with those conditions.

Using pharmacy event and medical claims data as well as zip code information for more than 500,000 Medicare beneficiaries, the researchers determined that there was broad variation across regions in the quality of prescribing after adjustment for demographic variables and level of health risk. For example, at the top of the scale, 44 percent of elderly beneficiaries in Alexandria, La., used high-risk drugs while only 11 percent in the Bronx, N.Y., did.

Regions where beneficiaries were more likely to be given prescriptions for high-risk or potentially harmful drugs did not necessarily spend more on drugs overall than regions where beneficiaries were less likely to use high-risk or harmful drugs.

In addition, the researchers found that regions where non-drug medical spending was higher also were the places where there was a greater likelihood of high-risk or harmful drugs being prescribed for Medicare beneficiaries.

"That contradicts the idea that high spending leads to better prescription practices," Dr. Zhang noted.

Katherine Baicker, Ph.D., and Joseph P. Newhouse, Ph.D., both of Harvard University, co-authored the paper.


Story Source:

The above story is based on materials provided by University of Pittsburgh Schools of the Health Sciences. Note: Materials may be edited for content and length.


Journal Reference:

  1. Zhang Y., Baicker K., Newhouse J.P. Geographic Variation in the Quality of Prescribing. New England Journal of Medicine, 2010; DOI: 10.1056/NEJMp1010220

Cite This Page:

University of Pittsburgh Schools of the Health Sciences. "Higher medication spending doesn't indicate better prescribing quality, study finds." ScienceDaily. ScienceDaily, 4 November 2010. <www.sciencedaily.com/releases/2010/11/101103171443.htm>.
University of Pittsburgh Schools of the Health Sciences. (2010, November 4). Higher medication spending doesn't indicate better prescribing quality, study finds. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2010/11/101103171443.htm
University of Pittsburgh Schools of the Health Sciences. "Higher medication spending doesn't indicate better prescribing quality, study finds." ScienceDaily. www.sciencedaily.com/releases/2010/11/101103171443.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Possible Ebola Patient in Isolation at California Hospital

Possible Ebola Patient in Isolation at California Hospital

Reuters - US Online Video (Aug. 20, 2014) — A patient who may have been exposed to the Ebola virus is in isolation at the Kaiser Permanente South Sacramento Medical Center. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Raw: World's Oldest Man Lives in Japan

Raw: World's Oldest Man Lives in Japan

AP (Aug. 20, 2014) — A 111-year-old Japanese was certified as the world's oldest man by Guinness World Records on Wednesday. Sakari Momoi, a native of Fukushima in northern Japan, was given a certificate at a hospital in Tokyo. (Aug. 20) Video provided by AP
Powered by NewsLook.com
Do More Wedding Guests Make A Happier Marriage?

Do More Wedding Guests Make A Happier Marriage?

Newsy (Aug. 20, 2014) — A new study found couples who had at least 150 guests at their weddings were more likely to report being happy in their marriages. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Freetown a City on Edge

Ebola-Hit Sierra Leone's Freetown a City on Edge

AFP (Aug. 19, 2014) — Residents of Sierra Leone's capital voice their fears as the Ebola virus sweeps through west Africa. Duration: 00:56 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins