Association Between Insurance Gaps and Continued Antihypertension Medication Usage in a US National Representative Population

被引:12
作者
Gai, Yunwei [1 ]
Gu, Ning Yan [2 ]
机构
[1] Babson Coll, Econ Div, Babson Pk, MA 02157 USA
[2] Univ So Calif, Dept Pharmaceut Econ & Policy, Los Angeles, CA USA
关键词
HEALTH-INSURANCE; UNINSURED ADULTS; LIFE-STYLE; HYPERTENSION; ACCESS; PERSISTENCE; COVERAGE; TRENDS; IMPACT; CARE;
D O I
10.1038/ajh.2009.188
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
BACKGROUND Medication persistence is important for adequate control of blood pressure. In this article, we assess the association between gaps in insurance coverage and continued anti hypertensive medication using a US national representative sample. METHODS We used three recent panels from the Medical Expenditure Panel Survey (MEPS). Our sample included hypertensive individuals 18-65 years of age. We identified four insurance categories: (i) continuous coverage by private insurance, (ii) continuous coverage by public insurance, (iii) single or multiple gaps in coverage, and (iv) continuously uninsured. Binary logit models were used to analyze the association between interruptions in medication and insurance after controlling for socioeconomic factors. Patients with continuous private insurance were used as the reference group. Results were weighted to adjust for oversampling and clustering in the survey. RESULTS There was no statistically significant difference in the probability of medication persistence between individuals with continuous private insurance (the reference group) and individuals with continuous public insurance (adjusted odds ratio (AOR) 1.324, 95% confidence interval (CI) 0.774-2.266, P = 0.304). Compared to the reference group, individuals with insurance gaps had lower odds of continuing their medication (AOR 0.636,95% CI 0.418-0.0.969, P = 0.035). Continuously uninsured individuals had even lower odds of medication persistence (AOR 0.462,95% CI 0.282-0.757, P = 0.002). Age, marital status, body mass index (BMI) change, and years of education were also associated with continued medication usage. CONCLUSION Studies focusing on current insurance status may underestimate the impact of health insurance gaps and the population at risk. Continuous insurance coverage is needed to increase continued anti hypertensive medication usage.
引用
收藏
页码:1276 / 1280
页数:5
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