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Influence of Pharmaceutical Copayment on Emergency Hospital Admissions: A 1978–2018 Time Series Analysis in Spain

Author

Listed:
  • Antonio Palazón-Bru

    (Department of Clinical Medicine, Miguel Hernández University, 03550 Alicante, Spain)

  • Miriam Calvo-Pérez

    (Primary Care Pharmacy Service, General University Hospital of Elda, 03600 Alicante, Spain)

  • Pilar Rico-Ferreira

    (Primary Care Pharmacy Service, General University Hospital of Elda, 03600 Alicante, Spain)

  • María Anunciación Freire-Ballesta

    (Primary Care Pharmacy Service, General University Hospital of Alicante, 03010 Alicante, Spain)

  • Vicente Francisco Gil-Guillén

    (Department of Clinical Medicine, Miguel Hernández University, 03550 Alicante, Spain
    Equal contribution.)

  • María de los Ángeles Carbonell-Torregrosa

    (Department of Clinical Medicine, Miguel Hernández University, 03550 Alicante, Spain
    Emergency Services, General University Hospital of Elda, 03600 Alicante, Spain
    Equal contribution.)

Abstract

No studies have evaluated the influence of pharmaceutical copayment on hospital admission rates using time series analysis. Therefore, we aimed to analyze the relationship between hospital admission rates and the influence of the introduction of a pharmaceutical copayment system (PCS). In July 2012, a PCS was implemented in Spain, and we designed a time series analysis (1978–2018) to assess its impact on emergency hospital admissions. Hospital admission rates were estimated between 1978 and 2018 each month using the Hospital Morbidity Survey in Spain (the number of urgent hospital admissions per 100,000 inhabitants). This was conducted for men, women and both and for all-cause, cardiovascular and respiratory hospital discharges. Life expectancy was obtained from the National Institute of Statistics. The copayment variable took a value of 0 before its implementation (pre-PCS: January 1978–June 2012) and 1 after that (post-PCS: July 2012–December 2018). ARIMA (Autoregressive Integrated Moving Average) (2,0,0)(1,0,0) models were estimated with two predictors (life expectancy and copayment implementation). Pharmaceutical copayment did not influence hospital admission rates (with p -values between 0.448 and 0.925) and there was even a reduction in the rates for most of the analyses performed. In conclusion, the PCS did not influence hospital admission rates. More studies are needed to design health policies that strike a balance between the amount contributed by the taxpayer and hospital admission rates.

Suggested Citation

  • Antonio Palazón-Bru & Miriam Calvo-Pérez & Pilar Rico-Ferreira & María Anunciación Freire-Ballesta & Vicente Francisco Gil-Guillén & María de los Ángeles Carbonell-Torregrosa, 2021. "Influence of Pharmaceutical Copayment on Emergency Hospital Admissions: A 1978–2018 Time Series Analysis in Spain," IJERPH, MDPI, vol. 18(15), pages 1-12, July.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:15:p:8009-:d:603824
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    References listed on IDEAS

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    1. Jaume Puig-Junoy & Santiago Rodríguez-Feijoó & Beatriz Lopez-Valcarcel, 2014. "Paying for Formerly Free Medicines in Spain After 1 Year of Co-Payment: Changes in the Number of Dispensed Prescriptions," Applied Health Economics and Health Policy, Springer, vol. 12(3), pages 279-287, June.
    2. Laia Maynou & Gabriel Coll-de-Tuero & Marc Saez, 2019. "The effects of copayment in primary health care: evidence from a natural experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1237-1248, November.
    3. Mas, Nuria & Cirera, Laia & Viñolas, Guillem, 2011. "Los sistemas de copago en Europa, Estados Unidos y Canadá: Implicaciones para el caso español," IESE Research Papers D/939, IESE Business School.
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