星级奖金支付对药物使用问题的差异的影响
Chi Chun Steve Tsang1, Joseph Garuccio1, Xiaobei Dong1
1Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 881 Madison Avenue, Memphis, TN 38163, USA.
Exploratory research in clinical and social pharmacy
|September 11, 2023
概括
医疗保险D部分星级评级奖金支付减少了黑人和白人在药物问题上的差异,但不是西班牙裔或亚洲人. 需要进一步的研究来了解这些多样化的影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差距 研究 研究 研究 研究
- 制药政策分析 制药政策分析
背景情况:
- 种族和民族少数群体不成比例地面临不适当药物使用的后果.
- 质量改善举措,如医疗保险D部分星级评级,被检查,以了解它们减轻这些差异的潜力.
研究的目的:
- 评估医疗保险D部分星级评级奖金支付对药物使用问题的种族和民族差异的影响.
- 确定对医疗保险优势处方药计划 (MAPD) 的奖金支付是否影响了自2012年以来的MUI的差异.
主要方法:
- 使用的二次医疗保险行政数据 (2010-2011年和2016-2017年) 与区域卫生资源文件相关联.
- 采用差异差异方法,将MAPD招生人 (干预) 与独立处方药计划 (PDP) 招生人 (比较) 进行比较.
- 分析了以星级评级为目标和非目标的MUI,使用后勤回归与种族/种族,时间段和MAPD计划的三向交互术语.
主要成果:
- 与MAPD中的白人患者相比,黑人患者在明星评级准的MUI的几率明显更高 (OR=1.83).
- 目标MUI中的黑白差异在MAPD中比PDP的奖金后实施中减少了更多 (OR=0.84).
- 对于西班牙裔白人,亚裔白人或其他白人群体,以及未被星级评级准的MUI,没有观察到差异的显著减少.
结论:
- 医疗保险D部分奖金支付与在特定药物使用问题上减少黑人与白人差异有关.
- 这些奖金支付的影响在不同种族/民族群体中似乎是异质的.
- 需要进一步调查,以阐明奖金支付对健康差异产生不同影响的原因.
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