The relationship between emergency department use and cost-related medication nonadherence among Medicare beneficiaries.
The relationship between emergency department use and cost-related medication nonadherence among Medicare beneficiaries.
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DOI：
10.1016/j.annemergmed.2013.04.013
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发表时间：
2013-11
影响因子：
6.2
通讯作者：
Soumerai, Stephen B.
中科院分区：
文献类型：
--
作者：
Blanchard, Janice;Madden, Jeanne M.;Ross-Degnan, Dennis;Gresenz, Carol Roan;Soumerai, Stephen B.
本研究的目的是评估医疗保险受益人中自我报告的与费用相关的不遵守药物治疗与急诊科利用之间的关系。我们假设报告与费用相关的药物不依从性 (CRN) 的人会更多地使用急诊科 (ED)。我们对 2006 年和 2007 年连续登记的 Medicare 受益人进行了一项回顾性队列研究。我们使用多元逻辑回归来评估 ED 使用和 CRN 之间的关系。我们的主要因变量是在评估 CRN 的初次访谈后 364 天内的任何急诊科就诊。我们的主要自变量是两个表示 CRN 的变量：轻度 CRN（定义为由于成本而减少药物剂量或延迟获得药物）和重度 CRN（定义为由于成本而根本没有配药）。我们的样本由 7177 名医疗保险成本受益人调查 (MCBS) MCBS 受访者组成。大约 7.5% 的受访者仅报告轻度 CRN（n=541），另有 8.2% 的受访者报告严重 CRN（n=581）。与所有 CRN 类别中没有 CRN 的残疾医疗保险受益人和没有 CRN 的老年医疗保险受益人相比，患有严重 CRN 的残疾医疗保险受益人更有可能至少接受一次急诊就诊（1.53，95% CI 1.03-2.26）。我们的结果显示严重的 CRN 与急诊科使用之间存在关联。即使在调整影响利用率的其他因素后，报告严重 CRN 的 65 岁以下残疾受益人更有可能至少去一次急诊科就诊。
The objective of this study was to evaluate the relationship between self reported cost-related nonadherence to medications and emergency department utilization among a population of Medicare beneficiaries. We hypothesized that persons who reported cost-related medication nonadherence (CRN) would have higher emergency department (ED) use. We conducted a retrospective cohort study of continuously enrolled Medicare beneficiaries from in 2006 and 2007. We used multivariate logistic regression to evaluate the relationship between ED use and CRN. Our principal dependent variable was any emergency department visit within a 364-day period after the initial interview assessing CRN. Our principal independent variables were two variables to denote CRN: mild CRN, defined as a reduction in medication dose or delay in getting medications because of cost, and severe CRN, defined as a medication not being filled at all due to cost. Our sample consisted of 7177 Medicare Cost Beneficiary Survey (MCBS) MCBS respondents. Approximately 7.5 percent of these respondents reported mild CRN only (n=541) and another 8.2 percent reported severe CRN (n=581). Disabled Medicare beneficiaries with severe CRN were more likely to have at least one ED visit (1.53, 95% CI 1.03–2.26) as compared to both disabled Medicare beneficiaries without CRN and elderly Medicare beneficiaries in all CRN categories. Our results show an association between severe CRN and emergency department use. Disabled beneficiaries under age 65 who report severe CRN were more likely to have at least one emergency department visit, even when adjusting for other factors that impact utilization.
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影响因子：
4.9
作者：
Fan, Lin;Shah, Manish N.;Friedman, Bruce
通讯作者：
Friedman, Bruce
影响因子：
--
作者：
Ho, P. Michael;Spertus, John A.;Rumsfeld, John S.
通讯作者：
Rumsfeld, John S.
影响因子：
168.9
作者：
HORWITZ, RI;VISCOLI, CM;SINDELAR, J
通讯作者：
SINDELAR, J
DOI：
10.1111/j.1532-5415.1983.tb03391.x
发表时间：
1983-01-01
影响因子：
6.3
作者：
KATZ, S
通讯作者：
KATZ, S
影响因子：
9.7
作者：
Lichtenberg, Frank R.;Sun, Shawn X.
通讯作者：
Sun, Shawn X.