The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia
Abstract Background Evidence shows that potentially inappropriate medication (PIM) use in older adults significantly increases the utilization of healthcare resources. PIM is widely prescribed in older adults, however little is known about its association with healthcare resource utilization in Afri...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-024-04688-w |
| _version_ | 1797349734377062400 |
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| author | Behailu Terefe Tesfaye Dula Dessalegn Bosho Gashahun Mekonnen Dissassa Mikiyas Gashaw Tesfaye Mengist Awoke Yizengaw |
| author_facet | Behailu Terefe Tesfaye Dula Dessalegn Bosho Gashahun Mekonnen Dissassa Mikiyas Gashaw Tesfaye Mengist Awoke Yizengaw |
| author_sort | Behailu Terefe Tesfaye |
| collection | DOAJ |
| description | Abstract Background Evidence shows that potentially inappropriate medication (PIM) use in older adults significantly increases the utilization of healthcare resources. PIM is widely prescribed in older adults, however little is known about its association with healthcare resource utilization in Africa, particularly Ethiopia. Therefore, the primary aim of this study was to examine the presence of an association between healthcare expenditure and the frequency of PIM used. Methods This observational study was conducted from 06 September 2021 to 30 December 2022. A total of 151 hospitalized older adult patients were included in the study. The data collection format was designed to capture relevant information. STATA V.15.0 was used for analysis. Descriptive statistics and a generalized linear model regression were conducted. Statistical significance was set at a p-value < 0.05. The findings are presented in tables, figures, and text. Results The total healthcare expenditure was higher in PIM users (385,368.6 ETB) than in non-PIM users (131,267.7 ETB). The median expenditures for medical supplies (p = 0.025), investigations (p = 0.033), and total healthcare expenditure (p = 0.023) were significantly higher in patients with two and more PIMs than in those with no or one PIM. However, after model adjustment, the total healthcare expenditure was not significantly different across the frequency of PIMs used. Number of medications (adjusted B = 0.068, 95% CI: 0.035, 0.101, p < 0.001) and taking blood and blood-forming organ class of medication (adjusted B = 0.151, 95% CI: 0.005, 0.297, p = 0.042) were associated with higher total healthcare expenditure, whereas the total healthcare expenditure was significantly lower in those patients with diseases of the nervous system (adjusted B = -0.307, 95% CI: -0.502, -0.112, p = 0.002) and respiratory system (adjusted B = -0.196, 95% CI: -0.327, -0.065, p = 0.003). Conclusion The total healthcare expenditure is nearly three times higher in PIM users. However, its association with the frequency of PIM use was not statistically significant in the final model. Deprescribing medications after evaluating the benefit-risk ratio may help to reduce the healthcare expenditures of older adult patients. Further similar, adequately powered, comparative study is also warranted to identify the actual effect of PIM use on healthcare expenditures in the local context. |
| first_indexed | 2024-03-08T12:34:40Z |
| format | Article |
| id | doaj.art-a8f225f802634b7981de5205c3b50500 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-08T12:34:40Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-a8f225f802634b7981de5205c3b505002024-01-21T12:34:15ZengBMCBMC Geriatrics1471-23182024-01-0124111010.1186/s12877-024-04688-wThe association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in EthiopiaBehailu Terefe Tesfaye0Dula Dessalegn Bosho1Gashahun Mekonnen Dissassa2Mikiyas Gashaw Tesfaye3Mengist Awoke Yizengaw4Department of Clinical Pharmacy, School of Pharmacy, Faculty of Health Sciences, Institute of Health, Jimma UniversityDepartment of Clinical Pharmacy, School of Pharmacy, Faculty of Health Sciences, Institute of Health, Jimma UniversityDepartment of Internal Medicine, School of Medicine, Institute of Health, Jimma UniversityDepartment of Laboratory, Clinical Chemistry Unit, Jimma Medical CenterDepartment of Clinical Pharmacy, School of Pharmacy, Faculty of Health Sciences, Institute of Health, Jimma UniversityAbstract Background Evidence shows that potentially inappropriate medication (PIM) use in older adults significantly increases the utilization of healthcare resources. PIM is widely prescribed in older adults, however little is known about its association with healthcare resource utilization in Africa, particularly Ethiopia. Therefore, the primary aim of this study was to examine the presence of an association between healthcare expenditure and the frequency of PIM used. Methods This observational study was conducted from 06 September 2021 to 30 December 2022. A total of 151 hospitalized older adult patients were included in the study. The data collection format was designed to capture relevant information. STATA V.15.0 was used for analysis. Descriptive statistics and a generalized linear model regression were conducted. Statistical significance was set at a p-value < 0.05. The findings are presented in tables, figures, and text. Results The total healthcare expenditure was higher in PIM users (385,368.6 ETB) than in non-PIM users (131,267.7 ETB). The median expenditures for medical supplies (p = 0.025), investigations (p = 0.033), and total healthcare expenditure (p = 0.023) were significantly higher in patients with two and more PIMs than in those with no or one PIM. However, after model adjustment, the total healthcare expenditure was not significantly different across the frequency of PIMs used. Number of medications (adjusted B = 0.068, 95% CI: 0.035, 0.101, p < 0.001) and taking blood and blood-forming organ class of medication (adjusted B = 0.151, 95% CI: 0.005, 0.297, p = 0.042) were associated with higher total healthcare expenditure, whereas the total healthcare expenditure was significantly lower in those patients with diseases of the nervous system (adjusted B = -0.307, 95% CI: -0.502, -0.112, p = 0.002) and respiratory system (adjusted B = -0.196, 95% CI: -0.327, -0.065, p = 0.003). Conclusion The total healthcare expenditure is nearly three times higher in PIM users. However, its association with the frequency of PIM use was not statistically significant in the final model. Deprescribing medications after evaluating the benefit-risk ratio may help to reduce the healthcare expenditures of older adult patients. Further similar, adequately powered, comparative study is also warranted to identify the actual effect of PIM use on healthcare expenditures in the local context.https://doi.org/10.1186/s12877-024-04688-wAgedPotentially inappropriate medicationHealthcare costsEthiopia |
| spellingShingle | Behailu Terefe Tesfaye Dula Dessalegn Bosho Gashahun Mekonnen Dissassa Mikiyas Gashaw Tesfaye Mengist Awoke Yizengaw The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia BMC Geriatrics Aged Potentially inappropriate medication Healthcare costs Ethiopia |
| title | The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia |
| title_full | The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia |
| title_fullStr | The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia |
| title_full_unstemmed | The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia |
| title_short | The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia |
| title_sort | association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in ethiopia |
| topic | Aged Potentially inappropriate medication Healthcare costs Ethiopia |
| url | https://doi.org/10.1186/s12877-024-04688-w |
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