信息技术、可及性改善与处方药使用

Journal of the European Economic Association · 2024 · [{"name": "Petri Böckerman", "affiliation": ["IZA - Institute of Labor Economics", "Labour Institute for Economic Research", "University of Jyväskylä"]}, {"name": "Mika Kortelainen", "affiliation": ["University of Turku", "Finnish Institute for Health and Welfare"]}, {"name": "Liisa T. Laine", "affiliation": ["University of Missouri"]}, {"name": "Mikko Nurminen", "affiliation": ["Social Insurance Institution"]}, {"name": "Tanja Saxell", "affiliation": ["VATT Institute for Economic Research", "Aalto University"]}]

中文摘要

摘要我们估计了一项旨在通过简化处方续签和改善信息提供来提高药物可及性、同时限制过度使用的卫生信息技术的影响。我们重点研究苯二氮䓬类药物，这是一类常见的精神健康与失眠处方药，疗效显著但存在成瘾风险。我们研究了芬兰全国电子处方系统在四年间的分批推广，并使用覆盖全体人口的个体层面行政数据集。我们发现，电子处方因增加了处方续签次数，提高了苯二氮䓬类药物的平均使用量，这一增幅在较年轻患者中最为明显。电子处方能够改善老年患者的健康状况，并可能有助于平衡药物可及性与过度使用之间的权衡。然而，在缺乏额外成瘾监测的情况下，电子处方也可能对较年轻患者产生非预期的健康后果，因为他们更有可能患上精神与行为健康障碍。

Abstract

Abstract We estimate the effects of health information technology designed to improve access to medication while limiting overuse through easier prescription renewal and improved information provision. We focus on benzodiazepines, a commonly prescribed class of mental health and insomnia medications, which are highly effective but potentially addictive. We study the staggered rollout of a nationwide electronic prescribing system over four years in Finland and use population-wide, individual-level administrative data sets. We find that e-prescribing increases average benzodiazepine use due to increased prescription renewals. The increase is most pronounced for younger patients. E-prescribing can improve the health of elderly patients and may help to balance the access-overuse trade-off. Without additional monitoring for addiction in place, it may, however, also have unintended health consequences for younger patients, who are more likely to develop mental and behavioral health disorders.