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根据美国全国女性立法者基金会进行的一项研究,限制获得长效止痛药实际上可能会增加而不是减少医疗补助的总体成本。在佛罗里达州,州代表盖尔·哈雷尔(Gayle Harrell)提出了这一发现,他警告说:“对我们来说,限制处方药物的使用是没有意义的,这些药物可以帮助病人避免更昂贵的医疗程序。”对随机抽样的68万名医疗补助处方药接受者的数据进行分析,以确定接受阿片类药物治疗的患者的发生率和医疗状况。结果表明,使用长效阿片类药物的患者已经在至少两种短效阿片类药物上失败,并且遭受的疾病几乎是服用短效阿片类药物的患者的两倍。数据表明,限制获得长效类阿片可能导致更多地使用其他更昂贵的医疗服务,如住院和手术。有趣的是,该研究还发现,西班牙裔患者占样本中使用处方药人群的49%,但仅占接受长效阿片类药物的患者的6%。虽然这些患者没有进行疾病严重程度的比较,但结果确实表明,对西班牙裔患者开具长效阿片类药物可能存在偏见。密苏里州众议员琳达·巴特尔斯迈耶呼吁佛罗里达州立法机构研究限制获得长效阿片类药物对患者和该州医疗补助预算的影响。她说:“我们认为,这些问题最好通过成立一个由患者、医生和疼痛管理倡导者组成的佛罗里达疼痛委员会咨询委员会来解决。”(来源:《新闻中的最后一幕》,2003年3月31日)
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Hospice news
Restricting access to long-acting pain medications may actually increase rather than decrease overall Medicaid costs, according to a study conducted for the US National Foundation of Women Legislators. Presenting the findings in Florida, State Representative Gayle Harrell warned, “it doesn’t make sense for us to limit access to prescription drugs that can help a patient avoid more costly medical procedures.” Data from a random sample of 680,000 Medicaid prescription drug recipients were analyzed to determine the occurrence and medical status of those patients treated with opioids. Results indicated that patients using long-acting opioid medications had already failed on at least two shortacting pain drugs and suffered from almost twice the number of ailments as patients taking short-acting opioids. The data indicates that restricting access to long-acting opioids can result in increased use of other, more expensive medical services, such as hospitalization and surgery. Interestingly, the study also found that Hispanic patients made up 49 percent of the prescribed drug population used in the sample but represented only 6 percent of those receiving longacting opioid medications. Although these patients were not compared for severity of illness, results do indicate a possible bias against prescribing longacting opioid medication to patients of Hispanic descent. Missouri State Representative Linda Bartelsmeyer called on the Florida Legislature to study just what the impact of limiting access to long-acting opioid medication would be on both patients and the state’s Medicaid budget. “We believe these issues could best be addressed by the creation of a Florida Pain Commission Advisory Board, comprised of patients, physicians, and pain management advocates,” she said. (Source: Last Acts in the News, March 31, 2003.)
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