在医疗保险受益者中潜在不适当的药物使用的种族和民族差异
Eli Raver1, Jeah Jung2, Caroline Carlin3
1Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus.
JAMA network open
|April 14, 2025
概括
与其他种族和民族群体相比,白人医疗保险受益者使用潜在不适当药物 (PIM) 的比例更高. 这些发现凸显了减少所有人群中PIM使用的必要性,以解决健康差异.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
背景情况:
- 老年人容易受到潜在不合适的药物 (PIMs) 的影响,在这种情况下,风险超过益处.
- 在PIM使用中的种族和民族差异可能会加剧健康不平等,并导致不良药物事件.
研究的目的:
- 调查种族/种族与老年医疗保险受益人PIM使用之间的关联.
- 识别高风险药物使用和有害药物疾病相互作用的潜在差异.
主要方法:
- 使用全国范围的医疗保险D部分,服务费索赔和医疗保险优势 (MA) 数据 (2016-2019) 的横截面研究.
- 分析包括65岁及以上的大量医疗保险受益者样本.
- 线性概率模型评估了患有痴呆症或患有摔倒史的患者的高风险药物使用和有害的药物疾病相互作用.
主要成果:
- 与亚洲/太平洋岛民,黑人和西班牙裔受益人相比,白人受益人使用高风险药物的比例更高.
- 白人受益者在患有痴呆症和患有摔倒史的患者中,潜在有害的药物疾病相互作用率也最高.
- 与传统医疗保险 (TM) 计划相比,在MA计划中观察到的PIM使用的种族和民族差异较小.
结论:
- 白人医疗保险受益人始终显示PIM使用率高于其他种族和民族群体.
- 这些差异可能部分归因于处方药的整体使用率的差异.
- 减少所有种族和种族群体的PIM使用对于减轻健康差异至关重要.
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