• Title/Summary/Keyword: DUR

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Factors associated with changes in pharmaceutical expenditures of outpatient care in clinic setting : Focusing on the incentive scheme to reduce total prescribed drug expenditure and the drug utilization review system (의원 외래환자의 약품비 변화 관련요인: 처방총액 절감 인센티브제도와 DUR 제도 시행 전후를 중심으로)

  • Yi, Myung-Hyun;Chung, Woojin;Cho, Eun;Kim, Roeul;Lee, Sunmi
    • Health Policy and Management
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    • v.22 no.4
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    • pp.561-578
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    • 2012
  • This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

Retrospective Drug Utilization Review of Drug-Drug Interaction Criteria Based on Real World Data: Analysis in Terms of Dispensing Types (건강보험심사청구 자료에 근거한 병용금기 약물의 후향적 약물사용평가 : 처방전 조제 형태별 분석)

  • Lee, Young-Sook;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.249-255
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    • 2011
  • Objective: To examine the drug use (prescribing) pattern of serious drug-drug interactions (DDIs, contraindicated drug interactions) using real world data. Prescription patterns were examined in terms of dispensing types. Method: Retrospective drug utilization review (DUR) study was performed. One hundred and six datasets of serious DDIs (DDI pairs) were determined among DDI datasets that Ministry of Health & Welfare announced for the DUR system from 2004 to 2005. Electronically transacted ambulatory patients' prescription database to Health Insurance Assessment and Review Services (HIRA) from July, 2005 to June, 2006 was collected with personal information deidentified and analyzed in terms of types of dispensing as a contributing factor. Results: After prescription data analysis per each patient, total number of DDI cases using 95 DDI pairs was 5,511, which accounted for 2.6 cases per patients. DDI cases between two drugs from each of community pharmacy dispensing- type prescription were considerable (63% vs. 24% in those from each of in-institutional dispensing-type prescription and vs. 13% in those from a community pharmacy dispensing-type prescription and an in-institutional dispensingtype prescription). Conclusions: DDI cases from different prescribers were found to be significant. Thus, the concurrent DUR process between prescriptions from different physicians and institutions should be implemented for the safe drug use.

A Study on Application of Islanding Detection Algorithm for Dispersed Generation Unit. (분산전원의 고립운전 검출 알고리즘 적용에 관한 연굴)

  • Jung Won Wook;Chung Il Yop;Moon Seung Il
    • Proceedings of the KIEE Conference
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    • summer
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    • pp.217-219
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    • 2004
  • The installation of small sized dispersed generation(DG) units operating in parallel with the utility supply presents several technical problems for the protection and control of the system. One of the critical concerns is the occurrence of islanding. Hence, this paper propose the Digital Universal Relay(DUR) including anti-islanding function as DG interconnection interface. The existent islanding detection algorithms are examined. And the most effective and reliable method of those is modified for DUR application. The modified algorithm is evaluated through the modeling of the test system by PSCAD/EMTDC.

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Development of Drug Utilization Review Guidelines for Therapeutic Duplication of Antipyretics, Analgesics, and Anti-inflammatory Drugs Registered in Korea (국내 허가된 해열.진통.소염제의 치료중복 주의 가이드라인 개발)

  • Lee, Young-Sook;Kim, Nam-Hyo;Sohn, Hyun-Soon;Choi, Kyung-Eob;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.213-220
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    • 2010
  • Therapeutic duplication (TD) is a serious problem that frequently occurring primarily in the ambulatory setting in Korea. Implementation of concurrent drug utilization review (DUR) is a promising way to reduce inappropriate prescription and dispensing, and improve patient safety. This study was aimed to develop the process of DUR module of TD. Sixty-five drug ingredients classified into the drug category of the antipyretic, analgesic, and anti-inflammatory drug approved in Korea (The KFDA-dess nated classification codes of 114 or 264) were reviewed for this purpose. The drug ingredients (and products) were reclassified based on WHO's Anatomical, Therapeutic and Chemical (ATC) classification system. The clinical practice guidelines, textbooks and product labels on therapeutic uses of these drugs in Korea and several fores n countries were reviewed. If the drugs were categorized into the same therapeutically duplicable class, they were defined not to be used concurrently because the concurrent use was "therapeutically duplicated (unnecessary or even harmful)". Among the studied drug products, the following 5 drug classes were considto beas "therapeutic duplication": (1), on-t tooid DURnti-inflammatory drugs (NSAIDs, including s Dicylates), (2),Anilidts, (3),Opioids, (4) Ergot Dk Doids and (5) 5-$HT_1$ receptor agonot s. Therefore, concurrent prescribing or dispensing of more than 2 drug ingredients any in the above same classes should be considered as TD and needed to be warrant for careful review by pharmacists before dispensing.

Retrospective Drug Utilization Review of Antibiotics for Respiratory Tract Infection(RTI) in Ambulatory Outpatient Care (외래 호흡기계 질환에서 항생제 사용에 대한 후향적 평가방안)

  • Kim, Dong-Sook;Bae, Green;Kim, Su-Kyeong;Lee, Hak-Seon;Kim, Yoon Jin;Lee, SukHyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.291-303
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    • 2012
  • As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.