Comparative analysis of drug use for the Uterine and adnexa patients after the introduction of DRG

Abstract

Background : The Introduction of DRG(Diagnosis Related Groups) practice is expected to cause changes in doctor's prescribing behavior. Thus this study was aimed to compare the changes of drug use pattern for the Uterine and adnexa patients after the introduction of DRG(Diagnosis Related Groups) practice. Methods : 83 patients who had the Uterine and Adnexa procedure at a hospital were selected : 50 cases for those who had operations before the DRG, whereas 33 cases after the DRG. Both the medical records and insurance claiming data were reviewed and drug use pattern was compared for two groups. Results : Drug cost decreased significantly by 17.0% (P=0.000), whereas the changes of total medical cost were not significantly changed after the introduction of DRG. For the parenteral medicines, both the amount of use and drug cost were significantly decreased(P=0.021, P=0.000). However the changes of oral and external drug use were not significant. With regard to antibiotics, average antibiotics drug cost for each case decreased by 11.9% from 348,789 to 307,214 won. Especially parenteral antibiotics cost decreased 14.8%. Average drug cost of anti-inflammatory analgesics, fluids, narcotics, antacids, digestives for each case were also decreased significantly by 11.3%, 43.5%, 80.4%, 37.2%, 15.1%, whereas there were no significant changes in other drugs. Also it showed the tendency of medication cost shifting: drug cost during the stay in hospital was reduced whereas it increased after discharge. Conclusion : Drug consumption and drug expenditure for the Uterine and adnexa patients decreased significantly after the introduction of DRG practice. DRG had a significant effect on drug use, especially on the parenteral antibiotics use.