Big data based analysis of the utilization of national essential medicines for elderly patients with medical insurance / 中华老年医学杂志

ABSTRACT

Objective To investigate the current status and characteristics of the use of essential medicines in Chinese Medicare patients aged 65 and over.Methods Using the database from China Medical Insurance Research Association's research group to statistically analyze the total amount and the average cost of chemical and biological essential medicines for outpatients and emergency cases according to age groups in 2013 2015,and ranking and analysis were focused on the expenditure and the number of prescriptions of essential medicines for patients aged 65 and over.Additional analyses were made based on four regions (Eastern,Central,West and Northeast) and medical institutions of different levels.Results The data included nearly 20 million items of medications (4.43 million for patients ≥65 years,) and 307 essential medicines.In Western China,the portion of consumption of national essential medicines by patients aged 65 and over was 46.68％,which was higher than in any other regions.The portion of consumption by tertiary hospitals was the highest among all levels of medical institutions (＞ 40.00％).In all regions and medical institutions,cardiovascular drugs,hormones and endocrine drugs,and antimicrobials were the top categories for patients aged above 65,in terms of both expenditure and prescription numbers.There were some differences in the rankings of prescription numbers for essential medicines between patients aged 65 and over and those aged below 65.The numbers of prescriptions of the top 20 drugs varied little in different regions and medical institutions,and only a few drugs' rankings were different.Conclusions There are some differences in categories and rankings of commonly used essential medicines between younger and elder patients with medical insurance,and cardiovascular drugs are the most commonly used in patients aged 60 and over.These are in line with the spectrum and pathophysiological characteristics of diseases in the elderly.The types of basic drugs most commonly used by outpatients aged 65 and over have stayed stable across regions,and can provide clinical data for the selection of essential medicines with full cost reimbursement for elderly patients.