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The association of potentially inappropriate medication use on health outcomes and hospital costs in community-dwelling older persons: a longitudinal 12-year study

Author

Listed:
  • Virva Hyttinen

    (University of Eastern Finland)

  • Johanna Jyrkkä

    (Finnish Medicines Agency)

  • Leena K. Saastamoinen

    (The Social Insurance Institution)

  • Anna-Kaisa Vartiainen

    (University of Eastern Finland)

  • Hannu Valtonen

    (University of Eastern Finland)

Abstract

Aims To determine (1) whether potentially inappropriate medication (PIM) use defined by the Meds75 + database is associated with fracture-specific hospitalisations and all-cause mortality, and (2) the association between PIM use and all-cause hospitalisation costs in a 12-year follow-up of a nationwide sample of people aged ≥ 65 years in Finland. Methods This is a longitudinal study of 20,666 community-dwelling older persons with no prior purchases of PIMs within a 2-year period preceding the index date (1 Jan 2002), who were followed until the end of 2013. Data were obtained from the Finnish Prescription Register, and it was accompanied by information on inpatient care, causes of deaths and socioeconomic status from other national registers. Propensity score matching (PSM) analysis was used to account for potential selection effect in PIM use. Cox proportional hazards regression was used to identify the time to the first fracture or death by comparing PIM-users (n = 10,333) with non-users (n = 10,333). The association between PIM use and hospital costs was analysed with a fixed effects linear model. Results PIM use was weakly associated with an increased risk of fractures and death. The association was stronger in the first PIM-use periods. Hospitalised PIM-users had 15% higher hospital costs compared to non-users during the 12-year follow-up. Conclusion PIM initiation was associated with an increased risk of fracture-specific hospitalisation and mortality and PIM-users had higher hospital costs than non-users. Health care providers should carefully consider these issues when prescribing PIM for older persons.

Suggested Citation

  • Virva Hyttinen & Johanna Jyrkkä & Leena K. Saastamoinen & Anna-Kaisa Vartiainen & Hannu Valtonen, 2019. "The association of potentially inappropriate medication use on health outcomes and hospital costs in community-dwelling older persons: a longitudinal 12-year study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 233-243, March.
  • Handle: RePEc:spr:eujhec:v:20:y:2019:i:2:d:10.1007_s10198-018-0992-0
    DOI: 10.1007/s10198-018-0992-0
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    References listed on IDEAS

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    1. Oliver Reich & Thomas Rosemann & Roland Rapold & Eva Blozik & Oliver Senn, 2014. "Potentially Inappropriate Medication Use in Older Patients in Swiss Managed Care Plans: Prevalence, Determinants and Association with Hospitalization," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-9, August.
    2. Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, February.
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    More about this item

    Keywords

    Potentially inappropriate medications; Older persons; Register-based study; Health outcomes; Hospital costs;
    All these keywords.

    JEL classification:

    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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