Historical trend of racial and ethnic disparities in meeting Medicare medication therapy management eligibility in non-Medicare population

被引:6
作者
Wang, Junling [1 ]
Zhang, Zhiping [2 ,3 ]
Spivey, Christina A. [1 ]
Chisholm-Burns, Marie [4 ]
机构
[1] Univ Tennessee, Coll Pharm, Dept Clin Pharm, Memphis, TN 38163 USA
[2] Duke Univ, Sch Med, Dept Biostat & Bioinformat, Durham, NC USA
[3] Duke Univ, Sch Med, Dept Med, Durham, NC 27706 USA
[4] Univ Tennessee, Coll Pharm, Memphis, TN 38163 USA
关键词
Non-Medicare; Medicare; Medication therapy management services; Eligibility; Disparities; ECONOMIC OUTCOMES; CRITERIA; PROGRAM; ACCESS; CARE;
D O I
10.1016/j.sapharm.2014.02.007
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Prior research examining racial and ethnic disparities in meeting Medicare medication therapy management (MTM) eligibility criteria among the non-Medicare population suggests minorities have lower likelihood of being eligible than non-Hispanic Whites (Whites). However, such research has not examined trends in disparities and whether these disparities may be expected to decrease over time based on historical data. Objectives: To examine trends in MTM eligibility disparities among the non-Medicare population from 1996-1997 to 2009-2010. Methods: This retrospective observational analysis used Medical Expenditure Panel Survey data from the two study periods. The MTM eligibility criteria used by health insurance plans in 2008 and 2010 were analyzed. Trends in disparities were examined by including interaction terms between dummy variables for 2009-2010 and non-Hispanic Blacks (Blacks)/Hispanics in a logistic regression. Interaction effects were estimated on both the multiplicative and additive terms. Main and sensitivity analyses were conducted to represent the ranges of the Medicare MTM eligibility thresholds used by health insurance plans. Results: According to the main analysis, Blacks and Hispanics were less likely to be eligible than Whites for both sets of eligibility criteria in 1996-1997 and in 2009-2010. Trend analysis for both sets of criteria found that on the multiplicative term, there were generally no significant changes in disparities between Whites and Blacks/Hispanics from 1996-1997 to 2009-2010. Interaction on the additive term found evidence that disparities between Whites and Blacks/Hispanics may have increased from 1996-1997 to 2009-2010 (e. g., in the main analysis between Whites and Hispanics for 2010 eligibility criteria: difference in odds = -0.03, 95% CI: [-0.03]-[-0.02]). Conclusions: Racial and ethnic minorities in the non-Medicare population experience persistent and often increasing disparities in meeting MTM eligibility criteria. Drug benefit plans should take caution when using elements of Medicare MTM eligibility criteria. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:904 / 917
页数:14
相关论文
共 31 条
[11]   Changing choices in health care: implications for equity, efficiency and cost [J].
Bevan, Gwyn ;
Helderman, Jan-Kees ;
Wilsford, David .
HEALTH ECONOMICS POLICY AND LAW, 2010, 5 (03) :251-267
[12]  
Buis M., 2013, STAT TIP 87 INTERPRE
[13]   The Asheville Project: Long-term clinical, humanistic, and economic outcomes of a community-based medication therapy management program for asthma [J].
Bunting, Barry A. ;
Cranor, Carole W. .
JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION, 2006, 46 (02) :133-147
[14]  
Centers for Medicare & Medicaid Services, 2011, 2010 MED D
[15]  
Centers for Medicare & Medicaid Services (CMS) HHS, 2005, Fed Regist, V70, P4193
[16]   Latino Disparities in Prescription Drug Use and Expenditures: A Nationally Representative Analysis [J].
Chen, Jie ;
Fang, Hai ;
Vargas-Bustamante, Arturo ;
Rizzo, John A. ;
Ortega, Alexander N. .
ANNALS OF PHARMACOTHERAPY, 2010, 44 (01) :57-69
[17]  
Cranor Carole W, 2003, J Am Pharm Assoc (Wash), V43, P173, DOI 10.1331/108658003321480713
[18]   Characteristics of older adults who meet the annual prescription drug expenditure threshold for Medicare medication therapy management programs [J].
Daniel, Gregory W. ;
Malone, Daniel C. .
JOURNAL OF MANAGED CARE PHARMACY, 2007, 13 (02) :142-154
[19]   Patient Self-Management Program for Diabetes: First-year clinical, humanistic, and economic outcomes [J].
Garrett, Daniel G. ;
Bluml, Benjamin M. .
JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION, 2005, 45 (02) :130-137
[20]  
Isetts BJ., Evaluating Effectiveness of the Minnesota Medication Therapy Management Care Program