公共卫生 公共卫生
1University of Maryland School of Public Health, College Park, MD, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
改善阿尔茨海默病和相关痴呆症 (ADRD) 的医疗保险受益人获得药物的机会与降低整体医疗保健成本有关. 更容易获得处方可以减少医疗保险总支出和D部分药物的自费费用.
科学领域:
- 老年学是一门学科.
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
背景情况:
- 检查了药物和医疗保健接入和医疗保险总成本 (包括B部分,D部分) 和自付处方费用之间的关系.
- 专注于65岁及以上的医疗保险服务费 (FFS) 受益者,他们被诊断患有阿尔茨海默病和相关痴呆症 (ADRD).
研究的目的:
- 调查如何获得药物和常规医疗保健影响医疗保健支出在医疗保险受益者与ADRD.
- 确定与进入障碍相关的特定成本驱动因素,如B部分,D部分和自付费用.
主要方法:
- 利用了来自医疗保健提供者和系统的消费者评估调查 (2018年,2019年,2021-2022年) 和医疗保险受益人总结文件的链接数据.
- 进行了横截面分析,使用具有逻辑正数和马分布的通用线性模型来管理偏斜的成本数据,并结合了调查权重和状态固定效应.
- 在前六个月内通过自我报告的测量对获得处方药的便利性进行药物获取评估.
主要成果:
- 更容易获得处方药与较低的医疗保险总成本 (系数 = -0.08,p = 0.001),D部分成本 (系数 = -0.20,p = 0.002) 和D部分自付费用 (系数 = -0.08,p = 0.019) 有关.
- 获得药物并没有显著影响B部分成本,而更容易获得例行医疗预约与更高的B部分成本 (系数 = 0.183,p = 0.003) 和自付B部分费用 (系数 = 0.223,p = 0.002) 相相关.
- 在社会脆弱地区的ADRD FFS患者的B部分成本明显较低 (系数 = -0.78,p = 0.001).
结论:
- 改善获得必要药物的机会对于管理ADRD患者的医疗费用至关重要.
- 虽然更容易获得药物降低了处方药的成本,但确保获得常规护理,包括在医生办公室中使用的B部分药物,对于痴呆症护理管理至关重要.
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