Determinants of older people’s preferences for dispensing doctors

Lukas Richter 1 *, Vera Hartmann 2
1 Vienna University of Economics and Business, Institute for Sociology and Social Research, Vienna, Austria 2 University of Vienna, Department of Sociology, Vienna, Austria

Korespondenční autor: Lukas Richter (lukas.richter@wu.ac.at)

ISSN 1804-7181 (On-line)

Full verze:
Full version

Submitted:12. 6. 2020
Accepted: 5. 11. 2020
Published online: 31. 12. 2020

Summary

Objectives: Dispensing doctors (DDs) are a central part of the medication supply in Austria. Nevertheless, they are controversial and research pays little attention to perspectives of user-groups, especially older people. Therefore, this article deals with determinants of older people’s approval of dispensing doctors.

Methods: For this purpose, data from a telephone survey with people over 60 years in Lower Austria are used and evaluated by means of a logit model.

Results: The results show that accessibility of medicines is a major reason for the preference of DDs. Key factors are availability of a pharmacy in close proximity (OR: 0.44), independent use of a car (OR: 1.54) and individual mobility due to health reasons (OR: 1.14).

Discussion: DDs are important for older people in terms of a spatially close drug supply. A pharmacy at the place of residence only outweighs the preference for DDs if it is actually accessible for older people (taking low travel costs into account).

Conclusions: The aim must be to improve access to medicines in all communities where there is no pharmacy within a reasonable distance for people with health problems or those with restricted mobility.

Keywords: Dispensing doctors; Lower Austria; Medication supply; Older people; Perceived age

Literatura

1. Bannert M, Iselin D (2015). Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage. SSRN Electronic Journal KOF Working Paper No. 387. DOI: 10.2139/ssrn.2618402.

2. Beck K, Kunze U, Oggier W (2004). Selbstdispensation: Kosten treibender oder Kosten dämpfender Faktor? [Self-dispensation: cost driving or cost dampening factor?]. Care Management 6: 33–36. DOI: 10.5167/UZH-123558 (German).

3. Blozik E, Rapold R, Reich O (2015). Prescription of Potentially Inappropriate Medication in Older Persons in Switzerland: Does the Dispensing Channel Make a Difference? Risk Manag Healthc Policy 8: 73–80. DOI: 10.2147/RMHP.S78179.

4. Bowling A, See-Tai S, Ebrahim S, Gabriel Z, Solanki P (2005). Attributes of Age-Identity. Ageing and Society 25 (4): 479–500. DOI: 10.1017/S01446­86X05003818.

5. Bunda S (2019). Österreichische Ärztekammer Warnt: Versorgungskrise Auf Dem Land Spitzt Sich Zu [Austrian Medical Association Warns: Supply Crisis in Rural Areas Worsening]. Press information. [online] [cit. 2020–05–22]. Available from: https://www.ots.at/…eaussendung/ OTS_20191119_OT­S0158/oesterre­ichische-aerztekammer-warnt-versorgungskrise-auf-dem-landspitzt-sich-zu (German).

6. Chamber of Pharmacists (2019). Apotheker: Nein zum Hausapotheken-Vorstoß der Ärzte [Pharmacists: No to dispensing doctors]. Press information. [online] [cit. 2020–05–22]. Available from: https://www.ots.at/…s-der-aerzte (German).

7. Eggleston K (2012). Prescribing Institutions: Explaining the Evolution of Physician Dispensing. Journal of Institutional Economics 8(2): 247–270. DOI: 10.1017/S17441­3741100052X.

8. Faisst K, Schilling J, Gutzwiller F (2000). The Quality of Dispensation of Prescriptive Medication from the Patients’ Point of View. Schweiz. Med. Wochenschr. 130: 434.

9. Federal Competition Authority (2018). Der Österreichische Apothekenmarkt [The Austrian Pharmacy Market]. Wien: Federal Competition Authority. [online] [cit. 2020–05–22]. Available from: https://www.bwb.gv.at/…ntlichungen/ Gesundheitsbran­chenuntersuchun­g_Apothekenmar­kt_BWB_DE.pdf (German).

10. Goldacre B, Reynolds C, Powell-Smith A, Walker AJ, Yates TA, Croker R, Smeeth L (2019). Do Doctors in Dispensing Practices with a Financial Conflict of Interest Prescribe More Expensive Drugs? A Cross-Sectional Analysis of English Primary Care Prescribing Data. BMJ Open 9(2): e026886. DOI: 10.1136/bmjopen-2018–026886.

11. Hassali MA (2015). Public Perceptions towards Implementation of Dispensing Separation: Results from a Cross Sectional Analysis. Journal of Pharmaceutical Care and Health Systems 02(04). DOI: 10.4172/2376–0419.1000143.

12. Huber CA, Reich O (2016). Medication Adherence in Patients with Diabetes Mellitus: Does Physician Drug Dispensing Enhance Quality of Care? Evidence from a Large Health Claims Database in Switzerland. Patient Prefer Adherence 10: 1803–1809. DOI: 10.2147/PPA.S115425.

13. Iizuka T (2008). Experts’ Agency Problems: Evidence from the Prescription Drug Market in Japan. The RAND Journal of Economics 38(3): 844–862. DOI: 10.1111/j.0741–6261.2007.00115.x.

14. Kaiser B, Schmid Ch (2016). Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland. Health Econ 25(1): 71–90. DOI: 10.1002/hec.3124.

15. Kriegel J, Rebhandl E, Reckwitz N, Hockl W (2016). Levers in Primary Health Care – Identifying Strategic Success Factors for Improved Primary Care in Upper Austria. Das Gesundheitswesen 78(12): 835–843. DOI: 10.1055/s-0041–110521.

16. Lim D, Emery J, Lewis J, Sunderland VB (2009). A Systematic Review of the Literature Comparing the Practices of Dispensing and Non-Dispensing Doctors. Health Policy 92(1): 1–9. DOI: 10.1016/j. healthpol.2009­.01.008.

17. Lim D, Emery JD, Lewis J, Sunderland VB (2011). Australian Dispensing Doctors’ Prescribing: Quantitative and Qualitative Analysis. Med J Aust 195(4): 172–175. DOI: 10.5694/j.1326–5377.2011. tb03272­.x.

18. Lim D, Sunderland VB, Lewis J, Emery J (2014). Dispensing Doctor: An Underutilised Resource?’ International Primary Health Care Reform Conference.

19. Liu Y-M, Kao Yang Y-H, Hsieh Ch-R (2009). Financial Incentives and Physicians’ Prescription Decisions on the Choice between Brand-Name and Generic Drugs: Evidence from Taiwan. J Health Econ 28(2): 341–349. DOI: 10.1016/j.jhe­aleco.2008.10­.009.

20. Meyer S (2016). Dispensing Physicians, Asymmetric Information Supplier-Induced Demand: Evidence from the Swiss Health Survey. International Journal of Health Economics and Management 16(3): 215–245. DOI: 10.1007/s10754–016–9187–3.

21. Munger MA, Ruble JH, Nelson SD, Ranker L, Petty RC, Silverstein S, et al. (2014). National Evaluation of Prescriber Drug Dispensing. Pharmacotherapy 34(10): 1012–1021. DOI: 10.1002/ phar.1461.

22. Perri M III, Kotzan JA, Carroll NV, Fincham JE (1987). Attitudes About Physician Dispensing Among Pharmacists, Physicians and Patient. American Pharmacy 27(10): 57–61. DOI: 10.1016/ S0160–3450(16)33344-X.

23. Pink LA, Hageboeck TL, Moore DL (1989). The Public’s Attitudes, Beliefs, and Desires Regarding Physician Dispensing and Pharmacists. Journal of Pharmaceutical Marketing & Management 4(2): 41–63. DOI: 10.3109/J058v0­4n02_04.

24. Reich O, Weins C, Schusterschitz C, Thöni M (2012). Exploring the Disparities of Regional Health Care Expenditures in Switzerland: Some Empirical Evidence. European J Health Econ 13(2): 193–202. DOI: 10.1007/s10198–011–0299-x.

25. Reisinger G, Pint J (2008). Ärztliche Hausapotheken: Panikmache völlig unbegründet [Dispensing doctors: scare tactics completely unfounded]. Press information. [online] [cit. 2020–05–16]. Available from: https://www.ots.at/…ausapotheken- panikmache-voellig-unbegruendet (German).

26. Riedler K (2014). Ärztemangel Und Versorgungssicher­heit [Shortage of Doctors and Supply Security]. ‘Qualitas’ Nr. 02/2014 Vom 17.06.2014. Seite 36, 37 Ressort: Ärztliches Qualitätszentrum, no. 02 (June): 36, 37 (German).

27. Shafie AA, Hassali MA, Azhar S, See OG (2012). Separation of Prescribing and Dispensing in Malaysia: A Summary of Arguments. Research in Social and Administrative Pharmacy 8(3): 258–262. DOI: 10.1016/j.sap­harm.2011.06.002.

28. Spuling SM, Miche M, Wurm S, Wahl H-W (2013). Exploring the Causal Interplay of Subjective Age and Health Dimensions in the Second Half of Life: A Cross-Lagged Panel Analysis. Zeitschrift für Gesundheitspsycho­logie 21(1): 5–15. DOI: 10.1026/0943–8149/a000084.

29. Sunderland VB, Burrows SD, Joyce AW (2006). A Comparative Evaluation of Pharmacy Services in Single and No Pharmacy Towns. Aus New Zealand Health Policy 3(1): 8. DOI: 10.1186/1743–8462– 3–8.

30. Trottmann M, Frueh M, Telser H, Reich O (2016). Physician Drug Dispensing in Switzerland: Association on Health Care Expenditures and Utilization. BMC Health Serv Res 16: 238. DOI: 10.1186/s12913–016–1470-y.

31. Weiss MC, Grey E, Harris M, Rodham K (2016). Dispensing Doctor Practices and Community Pharmacies: Exploring the Quality of Pharmaceutical Services. Primary Health Care Research & Development 17(01): 42–55. DOI: 10.1017/S14634­23615000092.

32. Wilcock M (2001). Dispensing Doctors and Non-Dispensing Doctors – a Comparison of Their Prescribing Costs. Int J Pharm Pract 9(3): 197–202. DOI: 10.1111/j.2042–7174.2001.tb01049­.x.