Doctors prescribing more drugs?

Health Affairs article looks at prescription trends

As employers and government programs spend ever-increasing amounts of money on prescription drugs, a Health Affairs article documents a significant increase in the rate at which physicians are writing prescriptions and otherwise recommending drugs to patients.

The article by Catharine Burt of the Centers for Disease Control and Prevention's National Center for Health Statistics found that drug mentions-new or continued prescriptions, over-the-counter drugs, immunizations, and allergy shots-rose 59 percent between 1985 and 1999. The prescription rate rose from 109 to 146 prescriptions per 100 physician office visits, and the rate of multiple prescriptions per visit rose 39 percent, Burt writes. New drug approvals, expanded prescription drug coverage by insurers, and direct-to-consumer advertising have driven the increased prescription rates, she finds.

Prescription drugs aren't alone in driving health care costs higher, however. Yale Medical School professor Benjamin Druss details the 15 most costly medical conditions in the United States. He finds that heart disease costs the nation the most money, but it is arthritis and other joint conditions that result in more disabled people and more days spent in the hospital than any other condition. The most days of work are lost as a result of back problems, Druss writes.

Another article profiles the states that spend the most and the least on health care. The article by Anne Martin and colleagues from the actuary's office of the Centers for Medicare and Medicaid Services (CMS) found that Massachusetts in 1998 spent more per person on health care than any other state, $4,810, while Utah spent the least, $2,731.

Quality takes a spotlight in the July/August issue of Health Affairs. Separate articles call for accreditation of outpatient surgery with particular attention to anesthesia safety; demonstrate how publishing mortality statistics improved cardiac surgery safety in New York; and propose public disclosure of data on quality to improve patient safety and clinical effectiveness.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. All articles from the July/August issue are available to subscribers here on the journal's Web site, www.healthaffairs.org. Abstracts and full text of selected articles are available to nonsubscribers.


©2002 Project HOPE-The People-to-People Health Foundation, Inc.