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Taejae Kim 1 Article
Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy
Taejae Kim, Young Kyung Do
J Prev Med Public Health. 2020;53(2):82-88.   Published online November 18, 2019
DOI: https://doi.org/10.3961/jpmph.19.090
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AbstractAbstract AbstractSummary PDF
Objectives
The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.
Summary
Korean summary
이 연구에서는 요양급여 청구자료를 기준으로 급성 상기도 감염에서 스테로이드를 처방하는 경우와 관련하여 다음과 같은 특징을 확인하였다. 첫째, 환자 특성과 기관 특성을 모두 고려하였을 때 진료과목과 기관의 종별 구분에서 감기 스테로이드 처방률은 상당한 변이를 보였다. 둘째, 약제급여적정성평가 항목에서 스테로이드가 제외된 직후 처방률이 시계열적으로 상승하였으며, 이는 처방 행태에 정책 요인이 중요한 영향을 미칠 수 있음을 뜻한다.

Citations

Citations to this article as recorded by  
  • Measurement of Ambulatory Medication Errors in Children: A Scoping Review
    Lisa Rickey, Katherine Auger, Maria T. Britto, Isabelle Rodgers, Shayna Field, Alayna Odom, Madison Lehr, Alexandria Cronin, Kathleen E. Walsh
    Pediatrics.2023;[Epub]     CrossRef
  • Trends and Patterns of Systemic Glucocorticoid Prescription in Primary Care Institutions in Southwest China, from 2018 to 2021
    Xiaoyi Li, Zhen Zeng, Xingying Fan, Wenju Wang, Xiaobo Luo, Junli Yang, Yue Chang
    Risk Management and Healthcare Policy.2023; Volume 16: 2849.     CrossRef
  • Effects of monthly evaluations on the rates of irrational antimicrobial prescription in the outpatient and emergency departments at Ningbo No. 6 Hospital, Ningbo, China
    Qiong Yang, Fangfang Yuan, Li Li, Jianfeng Jin, Junhong He
    European Journal of Medical Research.2022;[Epub]     CrossRef
  • Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China
    Xiaobo Luo, Shitao Yu, Zhen Zeng, Xunrong Zhou, Yuxi Liu, Lei Wang, Jiaqi Hu, Yue Chang
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza
    Ji Yoon Han, Eun Ae Yang, Jung-Woo Rhim, Seung Beom Han
    Medicina.2021; 57(12): 1385.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health