Use of internist's free time by ambulatory care Electronic Medical Record systems.

Methods | The Medical Expenditure Panel Survey is a nationally representative longitudinal household survey of health care use and expenditures for noninstitutionalized US civilians.2 The present study used 2010 Household Component and Prescribed Medicines files, which included information on the drug name, days of supply, and amount paid. Information on days of supply was not available before 2010. The institutional review board of the University of Tennessee Health Science Center approved the study and waived the need for informed consent. The study evaluated adults (aged >18 years) who had received at least 1 prescription drug in 2010. Users of the GDDP were defined as individuals who had used the GDDP at least once. If a prescribed medicine event had the total amount paid and days of supply equivalent to any GDDP offerings, the GDDP was coded as 1 (the coding was otherwise 0). Typical GDDP offerings were $4 for 30-day supplies and $10 for 90-day supplies as provided by Walmart, Target, and Kroger. Rite Aid, CVS, Walgreens, and Kmart had other GDDP offerings. Andersen’s3 behavioral model was used to identify factors associated with use of the GDDP. The logistic regression procedure in SAS, version 9.4 (SAS Institute Inc), was used to predict probabilities for different patient groups while controlling for complex survey sampling. We assumed that all prescription drug users had an opportunity to use the GDDP. We also assumed that physician prescribing behaviors, pharmacist practice styles, and pharmacy benefit designs occurred independently of each factor affecting use of the GDDP.