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Medication Nonadherence: The Role of Cost, Community, and Individual Factors.

Abstract：

OBJECTIVE:To explain the association of out-of-pocket (OOP) cost, community-level factors, and individual characteristics on statin therapy nonadherence. DATA SOURCES:BlueCross BlueShield of Texas claims data for the period of 2008-2011. STUDY DESIGN:A retrospective cohort of 49,176 insured patients, aged 18-64 years, with at least one statin refill during 2008-2011 was analyzed. Using a weighted proportion of days covered ratio, differences between adherent and nonadherent groups are assessed using chi-squared tests, t-tests, and a clustered generalized linear model with logit link function. PRINCIPAL FINDINGS:Statin therapy adherence, measured at 48 percent, is associated with neighborhood-level socioeconomic factors, including race/ethnicity, educational attainment, and poverty level. Individual characteristics influencing adherence include OOP medication cost, gender, age, comorbid conditions, and total health care utilization. CONCLUSIONS:This study signifies the importance of OOP costs as a determinant of adherence to medications, but more interestingly, the results suggest that other socioeconomic factors, as measured by neighborhood-level variables, have a greater association on the likelihood of adherence. The results may be of interest to policy makers, benefit designers, self-insured employers, and provider organizations.

journal_name

Health Serv Res

journal_title

Health services research

authors

Abbass I,Revere L,Mitchell J,Appari A

doi

10.1111/1475-6773.12547

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

1511-1533

issue

4

eissn

0017-9124

issn

1475-6773

journal_volume

52

pub_type

杂志文章

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