Veterans' Pharmacy and Health Care Utilization Following Implementation of the Medicare Part D Pharmacy Benefit

被引:3
|
作者
Stroupe, Kevin T. [1 ,2 ]
Bailey, Lauren [1 ,3 ]
Gellad, Walid F. [4 ,5 ]
Suda, Katie [1 ,3 ]
Huo, Zhiping [1 ]
Martinez, Rachael [1 ]
Burk, Muriel [6 ]
Cunningham, Francesca [6 ]
Smith, Bridget M. [1 ,7 ,8 ]
机构
[1] Edward Hines Jr Vet Affairs Hosp, Ctr Innovat Complex Chron Healthcare, 5000 South 5th Ave 151H,Bldg 1 B260, Hines, IL 60141 USA
[2] Loyola Univ Chicago, Dept Publ Hlth Sci, Maywood, IL USA
[3] Univ Illinois, Chicago, IL USA
[4] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA
[5] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
[6] Edward Hines Jr VA Hosp, Vet Affairs Pharm Benefit Management Serv, Hines, IL USA
[7] Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL USA
[8] Northwestern Univ, Chicago, IL 60611 USA
关键词
Medicare; utilization; veteran; pharmacy; RISK ADJUSTMENT; DUAL-USE; AFFAIRS; MORTALITY;
D O I
10.1177/1077558716643887
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
We examined associations between enrollment in Medicare Part D pharmacy benefits and changes in medication acquisition from Department of Veterans Affairs (VA) pharmacies. We included all women and a random 10% sample of men who were VA enrollees, 65 years old as of January 1, 2004, and alive through December 2007. We used difference-in-differences models with propensity score weighting to examine changes in medication acquisition between 2005 (before Part D was implemented) and 2007 (after Part D implementation) for veterans who were or were not Part D enrolled. Of 231,716 veterans meeting inclusion criteria, 49,881 (21.5%) were enrolled. While 30-day medication supplies decreased from 26.2 to 23.4 for enrolled veterans, they increased from 36.6 to 37.4 for nonenrolled veterans (difference-in-differences: -4.0, p < .001). Reductions in 30-day supplies were greater among veterans who were required to pay VA copayments for some or all medications and who used VA and Medicare outpatient services.
引用
收藏
页码:328 / 344
页数:17
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