ABSTRACT
BACKGROUND: The main objective of this article is to estimate the global cost related to the use of the two drugs (associated drugs, specialist visits, hospital admissions, plasma drug monitoring). METHODS: The drug prescriptions were extracted from the Information System of the Pharmaceutical Prescriptions of the Marche Region for each ATC code in the years 2008-2012 and the number of patients per year and other outcomes measure were obtained. RESULTS: 13,574 patients were treated with theophylline and 19,426 patients with doxophylline. The number of patients treated was approximately 5,000 per year. Co-prescription with other drugs, use of corticosteroids, mean number of visits and hospital admissions (per 100 patients) were lower for doxophylline vs theophylline (1.55vs5.50, 0.3vs0.7, 2.05vs3.73 and 1.57vs3.3 respectively). The annual mean cost per patient was 187.4 for those treated with doxophylline and 513.5 for theophylline. CONCLUSIONS: In our study, doxophylline resulted to be associated with a reduction of the overall cost.
Subject(s)
Bronchodilator Agents/therapeutic use , Health Care Costs , Respiratory Tract Diseases/drug therapy , Theophylline/analogs & derivatives , Acute Disease , Adrenal Cortex Hormones/administration & dosage , Aged , Bronchodilator Agents/economics , Chronic Disease , Drug Costs , Drug Monitoring/economics , Female , Hospitalization/economics , Humans , Italy , Male , Middle Aged , Respiratory Tract Diseases/economics , Respiratory Tract Diseases/physiopathology , Theophylline/economics , Theophylline/therapeutic useABSTRACT
Prospective payment systems (PPS) based on diagnosis related groups (DRG) has recently been introduced in Italy and has already changed certain practice patterns of medical staff. Treatment of chronic diseases and those which specifically address the elderly population, such as chronic heart failure (CHF), can be strongly conditioned by this kind of system. This paper concerns an overview of CHF patients within the DRG system, supported by age-related variables, re-admission rates and cost analysis. We analyzed a sample of four hospitals in Central Italy and 1987 patients were admitted for CHF. The results show that after DRG introduction, length of stay was shorter, but re-admission rate increased, especially where the elderly were concerned. Average costs of service provision decreased, mainly due to the reduction in length of stay. However, no reduction was reported in the quality of care in terms of available diagnostic and the rapeutic resources. These early data indicate a change in the practice patterns of medical staff, including the risk of untimely discharge of elderly patients suffering from chronic diseases, for whom a long term monitoring system of service quality would be necessary.
