Disparity Implications of Medicare Eligibility Criteria for Medication Therapy Management Services

被引:36
作者
Wang, Junling [1 ]
Mullins, C. Daniel [2 ]
Brown, Lawrence M. [3 ,4 ]
Shih, Ya-Chen Tina [5 ]
Dagogo-Jack, Samuel [6 ]
Hong, Song Hee [3 ]
Cushman, William C. [7 ,8 ]
机构
[1] Univ Tennessee, Coll Pharm, Dept Pharmaceut Sci, Memphis, TN 38163 USA
[2] Univ Maryland, Sch Pharm, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA
[3] Univ Tennessee, Dept Pharmaceut Sci, Memphis, TN 38163 USA
[4] Univ Tennessee, Ctr Medicat Therapy Management Serv, Memphis, TN 38163 USA
[5] Univ Texas MD Anderson Canc Ctr, Sect Hlth Serv Res, Dept Biostat, Houston, TX 77030 USA
[6] Univ Tennessee, Coll Med, Div Endocrinol Diabet & Metab, Memphis, TN 38163 USA
[7] Univ Tennessee, Coll Med, Dept Prevent Med & Med, Memphis, TN 38163 USA
[8] Vet Affairs Med Ctr, Prevent Med Sect, Memphis, TN USA
关键词
Disparity; MTM services; eligibility criteria; race; ethnicity; NON-HISPANIC BLACKS; ETHNIC DISPARITIES; RACIAL DISPARITIES; PRESCRIPTION DRUGS; WHITES; COST;
D O I
10.1111/j.1475-6773.2010.01118.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective To determine whether there would be racial and ethnic disparities in meeting eligibility criteria for medication therapy management (MTM) services implemented in 2006 for Medicare beneficiaries. Data Sources/Study Setting Secondary data analyses of the Medical Expenditure Panel Survey (2004-2005). Study Design Logistic regression and recycled predictions were used to test the disparities in meeting eligibility criteria across racial and ethnic groups. The eligibility thresholds used by health plans in 2006 and new thresholds recommended for 2010 were examined. Racial and ethnic disparities were examined by comparing non-Hispanic blacks (blacks) with non-Hispanic whites (whites) and comparing Hispanics with whites, respectively. Disparities were also examined among individuals with severe health problems. Principal Findings According to 2006 thresholds, the adjusted odds ratios for meeting eligibility criteria for blacks and Hispanics to whites were 0.36-0.60 (p <.05) and 0.13-0.46 (p <.05), respectively. Blacks and Hispanics would be 21-34 and 32-38 percent, respectively, less likely to be eligible than whites according to recycled predictions. Similar patterns were found using the 2010 eligibility thresholds and among individuals with severe health problems. Conclusions There would be racial and ethnic disparities in meeting MTM eligibility criteria. Future research is warranted to confirm the findings using data after MTM implementation.
引用
收藏
页码:1061 / 1082
页数:22
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