치과 외래처방의 실태 조사

Research on the Actual Condition of Dental Outpatient Prescriptions

이 연구는 치과진료에서 처방되는 약제를 분석함으로써 해당 치과병 의원의 정보 자료의 제공 등으로 자율적 개선 노력 유도 및 지속적인 처방행태 변화추이 공개로 적정처방 및 벤 치마킹유도와 국민에게 항생제, 주사제 등의 약제 사용실태 홍보로 적정 약제 사용을 위한 인식 변화 유도에 기여하고자 이 연구를 시행하였다. 2003년 7월 1일부터 9월 31일까지 요양기관 34,226개소의 건강보험 외래약제 처방내역을 이용하여 항생제, 주사제의 투약일수율 및 처방률, 투약일당 약품비, 처방건당 약품목수와 고가약품목수의 비중에 대해 분석한 결과 다음과 같은 결론을 얻었다. 1. 항생제에 대한 투약일수율은 치과의원이 90.11%로 전년 동기 및 전분기보다 낮게 나타났으나, 처방률은 15.50%로 전년 동기 및 전분기보다 높게 나타났다. 치과병원의 투약일수율과 처방율은 각각 71.57%와 21.05%로 전분기보다 다소 높게 나타났다. 타종별 요양기관보다는 치과 병 의원의 투약일수율은 매우 높으나 처방률은 낮게 나타났다. 2. 주사제에 대한 투약일수율과 처방률은 치과의원이 각각 0.13%과 0.05%로 전년 동기보다는 감소추세로 나타났으며, 치과병원의 투약일수율과 처방률도 각각 1.03%과 0.88%로 전분기보다 다소 낮게 나타났다. 타 요양기관 종별보다는 치과병 의원의 주사제 투약일수율과 처방률은 매우 낮은 것으로 나타났다. 3. 약품목수는 치과의원이 2.79개로 전년 동기보다는 낮아졌으나 전분기보다는 높게 나타났으며, 치과병원은 2.67개로 전년 동기 및 전분기에 비해 증가된 것으로 나타났다. 타종별 요양기관보다는 치과병 의원 모두 약품목수가 적은 것으로 나타났다. 4. 투약일당 약품비는 치과의원이 863원으로 전년 동기 및 전분기에 비해 증가추세로 나타났으며, 치과병원은 1,385원로 전분기보다 낮게 나타났다. 타종별 요양기관보다는 치과병 의원 모두 낮은 것으로 나타났다. 5. 고가약품목수 비중은 치과의원이 46.43%로 전분기보다 높게 나타났으며, 치과병원은 54.05%로 전분기보다 매우 높게 나타났다. 병 의원에 비해 치과병 의원이 고가약품 목수 비중이 높은 것으로 나타났다. 6. 지역별 외래처방 현황 분석시 항생제 처방률은 광주지역이 가장 높고 대전지역이 가장 낮은 것으로 나타났으며, 주사제 처방률은 2/4분기 결과와 마찬가지로 영남지역이 모두 높은 반면, 수도권 지역은 모두 낮은 처방률로 나타났으며, 지역별 변이도 매우 커 최대지역의 처방률이 최소지역의 처방률의 2배 이상 높은 것으로 나타났다. 투약일당 약품비는 울산지역이 가장 높고 전북지역이 가장 낮게 나타나며, 처방건당 약품목수는 경기지역이 가장 높고 제주지역이 가장 낮게 나타났다.

This study investigated the medicines prescribed in dental services in order to provide information and materials on dental clinics and hospitals, for the intention of leading the dental circle to make efforts for voluntary improvement, do adequate prescription, and attempt for bench marking through this unfolding of their tendency in continuous prescription behaviors, and leading the people to have a right recognition on adequate medicine use through this information on their medicine-taking behaviors including antibiotics and injections. From the records of outpatient prescriptions of medicines under health insurance over the period of June 1st to September 31th in 2003 in the 34,226 recuperation institutions, antibiotics and injections were analyzed into administration days, prescription frequency, medicine cost per administration day, the number of medicines per prescription, and the number weight of high priced medicines. The findings were as below: 1. Adminstration days of antibiotics was 90.11% in the dental clinics, which was a decrease than the same quarter and the previous quarter of the previous year. While the prescription frequency of antibiotics was 15.5%, higher than the same quarter and the previous quarter of the previous year. In dental hospitals, administration days and prescription frequency of antibiotics were 71.57% and 21.05%, respectively, a little higher than the previous quarter. Compared to other kind of recuperation institutions, dental clinics and hospitals had higher administration days and lower prescription frequency. 2. For injections, adminstration days and prescription frequency in dental clinics were 0.13% and 0.05%, respectively, which were decreases than the same quarter of the previous year. In dental hospitals, adminstration days and prescription frequency were 1.03% and 0.88%, respectively, a little lower than those of the previous quarter. Compared to other kind of recuperation institutions, dental clinics and hospitals were very lower in injection administration days and injection prescription frequency. 3. The number of prescribed medicines was 2.79 in the dental clinics, which was lower than the same quarter of the previous year but higher than the previous quarter. Dental hospitals put 2.67 numbers of medicines per prescription, an increase than the same quarter of the previous year and the previous quarter. Compared to other kind of recuperation institutions, dental clinics and hospitals put smaller number of medicines per prescription. 4. Medicine cost per administration day was 863 won in the dental clinics, which was an increase than the same quarter of the previous year and in the previous quarter. Compared to other kind of recuperation institutions, dental clinics and hospitals had lower medicine cost per administration day. 5. The number weight of high priced medicines was 46.43% in dental clinics, which was an increase than the previous quarter. In dental hospitals, it was 54.05%, so remarkable an increase than the previous quarter. Compared to other kind of hospitals and clinics, dental clinics and hospitals prescribed larger number of high priced medicines. 6. By districts, the frequency of antibiotics prescriptions was the highest in Kwanju and the lowest in Daejeon. The frequency of injection prescriptions was high in all Youngnam districts as was in the second quarter, while low in all the Metropolitan districts. There was a large variation in the prescription frequency to the districts, as the district of the highest prescription frequency had more than 2 times larger frequency than the district of the lowest frequency. Medicine cost per administration day was the highest in Ulsan but the lowest in the north part of Cholla province. The number of medicines per prescription was the largest in Kyonggi province while the smallest in Cheju-do.