[Introduction of the electronic prescription in a primary care district: impact on pharmaceutical expenditure and the factors determining its use]

Aten Primaria. 2013 Mar;45(3):133-9. doi: 10.1016/j.aprim.2012.09.016. Epub 2012 Nov 28.
[Article in Spanish]

Abstract

Objective: To analyse the impact of using the electronic prescription on pharmaceutical expenditure (PE), and to explore the factors determining its use.

Methods: Two multiple regression models were constructed. For these two models, the PE and the percentage of electronic prescription use were taken respectively as dependent variables. Data from nine Primary care centres were included.

Results: Each point increase in prescription by active principle (PAP) was associated with an average reduction of 2,079 PE € per year. In contrast, every percentage increase in the use of electronic prescriptions was associated with an annual increase of 1,027 €. In addition, factors like card adjusted for age and type of pharmacy (TAFE) allocated (€ 36.71/year), the burden of care (€ 2,585/year) and frequency of clinic visits (€ 17,148/year), were also associated with increased PE. The other factors associated with an increase in the electronic prescriptions were, lower rurality rates, greater distance from the capital, greater PAP, as well as less clinic visits.

Conclusions: Electronic prescription use seems to be a predictor of pharmaceutical expenditure in which every percentage increase relates to an average annual increase of 1,027 Euros. This variable along with the prescription by active principle, and the amount of TAFEs assigned, as well as the burden of care and number of visits, are variables which help to explain more than 65% of the PE variability between physicians. Likewise, the increase in expenditures related to electronic prescriptions seems to occur at the expense of increasing number of prescriptions per patient.

Objetivo: Analizar las implicaciones del uso de receta electrónica sobre el gasto farmacéutico (GF) así como explorar factores determinantes de su utilización.

Métodos: Construcción de 2 modelos de regresión múltiple, tomando en uno de ellos como variable dependiente el GF y en el otro el porcentaje de prescripción mediante receta electrónica, incluyendo datos referidos a 9 centros de atención primaria de Andalucía.

Resultados: Cada incremento en un punto de prescripción por principio activo (PPA) se relacionó con una reducción media del GF de 2.079 €/año, mientras que cada incremento porcentual en el uso de receta electrónica se relacionó con un aumento de 1.027 € anuales. También se relacionaron con un mayor GF cada tarjeta ajustada por edad y tipo de farmacia (TAFE) asignada (36,71 €/año), la presión asistencial (2.585 €/año) y la frecuentación (2.17.148 €/año).Los factores que se relacionaron con un mayor uso de receta electrónica fueron un menor índice de ruralidad, una mayor distancia a la capital, una mayor PPA y una menor frecuentación.

Conclusiones: La prescripción mediante receta electrónica parece ser una variable predictora del gasto farmacéutico, relacionándose cada incremento porcentual con un incremento medio anual de 1.027 euros. Esta variable, junto con la prescripción mediante principio activo, el número de TAFE asignadas, la frecuentación y la presión asistencial media, contribuyen a explicar más del 65% de la variabilidad en el GF entre facultativos. El incremento del gasto relacionado con la receta electrónica parece producirse a expensas del aumento en el número de prescripciones por paciente.

Publication types

  • English Abstract
  • Multicenter Study

MeSH terms

  • Drug Costs*
  • Electronic Prescribing / economics*
  • Female
  • Health Expenditures*
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care*
  • Spain