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Influence of Pharmaceutical Copayment on Emergency Hospital Admissions: A 1978–2018 Time Series Analysis in Spain

Antonio Palazón-Bru, Miriam Calvo-Pérez, Pilar Rico-Ferreira, María Anunciación Freire-Ballesta, Vicente Francisco Gil-Guillén and María de los Ángeles Carbonell-Torregrosa
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Antonio Palazón-Bru: Department of Clinical Medicine, Miguel Hernández University, 03550 Alicante, Spain
Miriam Calvo-Pérez: Primary Care Pharmacy Service, General University Hospital of Elda, 03600 Alicante, Spain
Pilar Rico-Ferreira: Primary Care Pharmacy Service, General University Hospital of Elda, 03600 Alicante, Spain
María Anunciación Freire-Ballesta: Primary Care Pharmacy Service, General University Hospital of Alicante, 03010 Alicante, Spain
Vicente Francisco Gil-Guillén: Department of Clinical Medicine, Miguel Hernández University, 03550 Alicante, Spain
María de los Ángeles Carbonell-Torregrosa: Department of Clinical Medicine, Miguel Hernández University, 03550 Alicante, Spain

IJERPH, 2021, vol. 18, issue 15, 1-12

Abstract: No studies have evaluated the influence of pharmaceutical copayment on hospital admission rates using time series analysis. Therefore, we aimed to analyze the relationship between hospital admission rates and the influence of the introduction of a pharmaceutical copayment system (PCS). In July 2012, a PCS was implemented in Spain, and we designed a time series analysis (1978–2018) to assess its impact on emergency hospital admissions. Hospital admission rates were estimated between 1978 and 2018 each month using the Hospital Morbidity Survey in Spain (the number of urgent hospital admissions per 100,000 inhabitants). This was conducted for men, women and both and for all-cause, cardiovascular and respiratory hospital discharges. Life expectancy was obtained from the National Institute of Statistics. The copayment variable took a value of 0 before its implementation (pre-PCS: January 1978–June 2012) and 1 after that (post-PCS: July 2012–December 2018). ARIMA (Autoregressive Integrated Moving Average) (2,0,0)(1,0,0) models were estimated with two predictors (life expectancy and copayment implementation). Pharmaceutical copayment did not influence hospital admission rates (with p -values between 0.448 and 0.925) and there was even a reduction in the rates for most of the analyses performed. In conclusion, the PCS did not influence hospital admission rates. More studies are needed to design health policies that strike a balance between the amount contributed by the taxpayer and hospital admission rates.

Keywords: pharmacy; copayment; health expenditures; cost control; hospitalization; inpatients (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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