The Impact of Pharmaceutical Home Care on Medical Utilization for Frequent Users of Outpatient Services in Taiwan

Chien-Ying Lee, Heng-Hsuan Su, Yu-Chia Chang, Tung-Han Tsai, Yung-Rung Lai and Kuang-Hua Huang
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Chien-Ying Lee: Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Heng-Hsuan Su: National Health Insurance Administration, Ministry of Health and Welfare, Taipei 106211, Taiwan
Yu-Chia Chang: Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
Tung-Han Tsai: Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan
Yung-Rung Lai: Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Kuang-Hua Huang: Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan

IJERPH, 2021, vol. 18, issue 14, 1-12

Abstract: Due to the high-accessibility and low-copayment of healthcare system in Taiwan, the clinical visit frequency of people is relatively high, which often leads to an excessively high healthcare expenditure. The aim of this research was to explore the effectiveness of pharmaceutical home care for frequent users of outpatient service and to analyze the impact of pharmaceutical home care on medical utilization. The study was based on the Taiwan National Health Insurance Research Database. Patients with over 100 clinical visits during 2010 to 2012 were selected as subjects. Whether these patients participate the experimental plan of pharmaceutical home care in the following year and the medical utilization of the research subjects were analyzed to compare the difference between participating group and non-participating group in this plan. The generalized estimating equation was employed to examine the difference of medical utilization. A total of 3943 subjects were included in this study, including 591 patients (14.99%) participating in the experimental plan. The average number of physician visits during the following year of the participating group was higher than that of the non-participating group by 0.12 visits, and the outpatient medical expense was lower than the non-participating group by 18,302 points (1 point = 0.03 US dollars). After participating in the plan, the average number of clinical visits of frequent users of outpatient services was significantly reduced by 6.63 visits, and the outpatient expense was significantly decreased by 9871 points. After joining the experimental plan of pharmaceutical home care, the average number of outpatient visits decreased significantly and the medical expense was lower when compared with those who did not participate in the plan.

Keywords: pharmaceutical care; utilization review; ambulatory care; primary healthcare (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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