• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文学位 >Topics in Medicare Prescription Drug Enrollment in the Low-Income Subsidy Population.
【24h】

Topics in Medicare Prescription Drug Enrollment in the Low-Income Subsidy Population.

机译：低收入补贴人群中的Medicare处方药注册主题。

获取原文
获取原文并翻译 | 示例
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

In Medicare Part D, random assignment and potential yearly reassignment to premium-free stand-alone prescription drug plans (PDPs) is the default plan enrollment option for low-income subsidy (LIS) recipients. Randomization can cause medication access issues, but the impacts on medication use remain unclear because those who choose plans have not been separately examined. Medicare Advantage prescription drug plans (MAPDs) and tailored dual eligible Special Needs Plans (D-SNPs) have financial incentives to improve the medication adherence of Medicare-Medicaid dual eligibles compared to Medicare fee-for-service (FFS), but this relationship has not been assessed.;The study used 2006-2009 Medicare administrative data and a customized dataset that differentiated plan election types.;In aim 1, 29,784 LIS recipients assigned in 2007 were followed for three years and only 26% became choosers, with half selecting MA plans. PDP choosers appeared sicker and had higher Part D costs than non-choosers. In contrast, MA enrollees had fewer chronic conditions and lower costs than non-choosers. Choosers' plans covered more drugs than non-choosers' plans.;In aim 2, medication use and costs were compared among 28,610 statin users who either accepted or opted out of reassignment. Cross-sectional and difference-in-differences (DID) regression models examined changes in statin use and costs. Compared to reassignees, the 7.6% who opted out were less likely to discontinue (-0.8%) and switch statins (-7.0%) and exhibited relative increases over time in brand name use (6.8%) and 30-day fill costs to Medicare (;In aim 3, drug adherence with statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) was compared for samples of dual eligibles enrolled in FFS, MAPDs, and D-SNPs over 24 months, including subsamples who switched from FFS to managed care. Analyses included cross-sectional and DID regressions. Drug adherence was slightly higher among managed care dual eligibles when compared to FFS dual eligibles, but a percentage of those switching from FFS experienced disruptions in use.;In conclusion, few randomized LIS recipients choose their own plans. Opting out of reassignment has minimal impact on statin adherence and costs. Additional safeguard policies are needed for dual eligibles switching from FFS to Medicare managed care.
机译：在Medicare D部分中，对低收入补贴（LIS）接收者的默认计划注册选项是对免费保费独立处方药计划（PDP）的随机分配和潜在的年度重新分配。随机化可能会导致药物使用问题，但对药物使用的影响尚不清楚，因为选择计划的人尚未单独检查。与Medicare收费服务（FFS）相比，Medicare Advantage处方药计划（MAPD）和量身定制的双重合格特殊需求计划（D-SNP）具有经济上的诱因，可以提高Medicare-Medicaid双重合格者的药物依从性。该研究使用了2006-2009年Medicare行政数据和一个定制的数据集来区分计划的选举类型。在目标1中，对2007年分配的29,784名LIS接受者进行了三年跟踪，只有26％的选择者成为了选择者，一半的选择者MA计划。与非选择者相比，PDP选择者显得病态且D部分的费用更高。相反，与非选择者相比，MA参与者的慢性病更少，成本更低。选择者的计划比非选择者的计划覆盖更多的药物。在目标2中，比较了接受或选择退出重新分配的28,610个他汀类药物使用者的药物使用和费用。横断面和差异差异（DID）回归模型检查了他汀类药物使用和成本的变化。与重新分配的人员相比，退出的7.6％接受停药（-0.8％）和转换他汀类药物（-7.0％）的可能性较小，并且随着时间的推移，使用名牌药物（6.8％）和30天医疗保险费用的相对增加（;在目标3中，比较了在24个月内参加FFS，MAPD和D-SNP的双重合格样本中他汀类药物和血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（ACEIs / ARBs）的药物依从性，包括转换后的子样本从FFS到有管理的护理。分析包括横断面和DID回归。与FFS有双重资格的人相比，有管理有双重资格的人的药物依从性稍高，但是从FFS转换为有服务的人的使用受到干扰。 LIS随机接受者选择自己的计划，退出重新分配对他汀类药物依从性和费用的影响最小，双重合格人员从FFS转向Medicare管理的护理需要额外的保障政策。

著录项

  • 作者

    Hendrick, Franklin Benjamin.;

  • 作者单位

    University of Maryland, Baltimore.;

  • 授予单位 University of Maryland, Baltimore.;
  • 学科 Pharmaceutical sciences.
  • 学位 Ph.D.
  • 年度 2016
  • 页码 143 p.
  • 总页数 143
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 地球物理学;
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号