Corvinus
Corvinus

Lower fragmentation of coordination in primary care is associated with lower prescribing drug costs-lessons from chronic illness care in Hungary

Lublóy, Ágnes and Keresztúri, Judit Lilla and Benedek, Gábor (2017) Lower fragmentation of coordination in primary care is associated with lower prescribing drug costs-lessons from chronic illness care in Hungary. Working Paper. Corvinus University of Budapest Faculty of Economics, Budapest.

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A shorter version of this paper is published in the European Journal of Public Health: Ágnes Lublóy, Judit Lilla Keresztúri, Gábor Benedek; Lower fragmentation of coordination in primary care is associated with lower prescribing drug costs-lessons from chronic illness care in Hungary. European Journal of Public Health 2017, published online ahead of print 09 July 2017. doi: https://doi.org/10.1093/eurpub/ckx096

Abstract

Improved patient care coordination is critical for achieving better health outcome measures at reduced cost. Better integration of primary and secondary care in chronic illness care and utilizing the advantages of better collaboration between general practitioners and specialists may support these conflicting goals. Assessing patient care coordination at system level is, however, as challenging as achieving it. Based on prescription data from a private data vendor company, we develop a provider-level care coordination measure to assess the function of primary care at system level. We aim to provide empirical evidence for the possible impact of patient care coordination in chronic illness care—we investigate whether the type of collaborative relationship general practitioners have built up with specialists is associated with prescription drug costs. To our knowledge, no large-scale quantitative study has ever investigated this association. We find that prescription drug costs for patients treated by general practitioners who build up strong collaborative relationships with specialists are significantly lower than for patients treated by general practitioners characterized by fragmented collaborative structures. If future system-level studies in other settings confirm that total healthcare costs are indeed lower for patients treated in strong collaborative structures, then healthcare strategists need to advocate a healthcare system with lower care fragmentation on the interface of primary and secondary care. Regulating access to secondary care might result in significant cost savings through improved care coordination.

Item Type:Monograph (Working Paper)
Series Name:Corvinus Economics Working Papers - CEWP
Series Number / Identification Number:2017/04
Uncontrolled Keywords:chronic illness care, care coordination, primary care, secondary care, administrative data, prescription drug costs
JEL classification:C12 - Hypothesis Testing: General
H51 - National Government Expenditures and Health
I18 - Health: Government Policy; Regulation; Public Health
Subjects:Mathematics, Econometrics
Finance
Social welfare, insurance, health care
ID Code:2988
Deposited By: Ádám Hoffmann
Deposited On:20 Jul 2017 13:06
Last Modified:20 Jul 2017 13:06

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