Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Jul 19, 2018
Open Peer Review Period: Jul 23, 2018 - Sep 17, 2018
Date Accepted: Mar 23, 2020
(closed for review but you can still tweet)
Using mHealth to evaluate therapeutic duplication in Taiwan hospitals for patients with high blood pressure, high blood sugar, and high blood lipids
ABSTRACT
Background:
Cardiovascular disease (CVD) causes approximately half of all deaths in patients with type 2 diabetes. Duplicative prescriptions of medication in patients with high blood pressure (hypertension), high blood sugar (hyperglycemia), and high blood lipids have attracted close attention about the abuse of healthcare resources and preventive measures for such abuse. Duplicative prescriptions may occur through duplicative prescriptions by which patients receive redundant medications for the same condition from two or more sources such as doctors, hospitals, and multiple providers, or as a result of the patient’s wandering.
Objective:
We evaluated the degree of duplicative prescriptions in Taiwanese hospitals for outpatients with the three types of redundant medications, and then used an online dashboard using mHealth on a map to determine whether the situation has improved in the recent 25 fiscal quarters.
Methods:
Data on duplicate prescription rates of drugs for the diseases above from the third quarter of 2010 to the third quarter of 2016 were downloaded from the website of Taiwan’s National Health Insurance Administration (TNHIA). For the three types of drugs(i.e., anti-hypertension, anti- hyperglycemia, and anti-high blood lipids), 408, 414, and 359 hospitals with complete data of the three types of drugs mentioned above were included in the study. We used scale quality indicators to (1) assess the attributes of the study data using scale quality indicators, (2) create a dashboard that can be traced using mHealth, and (3) select the hospital levels that perform better in performance improvement on the three types of drugs using the weighted scores across types of hospital and percentages of performance on an online dashboard. We used Kendall’s coefficient of concordance (W) to evaluate whether the performance rankings are unanimous.
Results:
We found that (1) data quality is acceptable and effectively shows reliability and construct validity, (2) an online dashboard using mHealth on Google Maps allows easy and clear interpretation of duplicative prescriptions regarding hospital performance using multidisciplinary functionalities and show the significant improvement of trends in the reduction of duplicative prescriptions among all types of hospital, and (3) medical centers and regional hospitals gain a performance improvement in the three types of duplicative prescriptions better than the district hospitals do. Kendall’s W = 0.78, indicating all the performance rankings, is not unanimous ( = 4.67, d.f. = 2, p = 0.10).
Conclusions:
The demonstration of a dashboard using mHealth on a map can inspire 42 other quality indicators of TNHIA to be used by hospitals in the future. Clinical Trial: Not available
Citation
Per the author's request the PDF is not available.
Copyright
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