Abstract:
BACKGROUND:Adherence to medication treatment plans is important for chronic disease (CD) management. Cost-related nonadherence (CRN) puts patients at risk for complications. Native Hawaiians and Pacific Islanders (NHPI) suffer from high rates of CD and socioeconomic disparities that could increase CRN behaviors. OBJECTIVE:Examine factors related to CRN to medication treatment plans within an understudied population. RESEARCH DESIGN:Using 2014 NHPI-National Health Interview Survey data, we examined CRN among a nationally representative sample of NHPI adults. Bonferroni-adjusted Wald test and multivariable logistic regression were performed to examine associations among financial burden-related factors, CD status, and CRN. RESULTS:Across CD status, NHPI engaged in CRN behaviors had, on an average, increased levels of perceived financial stress, financial insecurity with health care, and food insecurity compared with adults in the total NHPI population. Regression analysis indicated perceived financial stress [adjusted odds ratio (AOR)=1.16; 95% confidence intervals (CI), 1.10-1.22], financial insecurity with health care (AOR=1.96; 95% CI, 1.32-2.90), and food insecurity (AOR=1.30; 95% CI, 1.06-1.61) all increase the odds of CRN among those with CD. We also found significant associations between perceived financial stress (AOR=1.15; 95% CI, 1.09-1.20), financial insecurity with health care (AOR=1.59; 95% CI, 1.19-2.12), and food insecurity (AOR=1.31; 95% CI, 1.04-1.65) and request for lower cost medication. CONCLUSIONS:This study demonstrated health-related and non-health-related financial burdens can influence CRN behaviors. It is important for health care providers to collect and use data about the social determinants of health to better inform their conversations about medication adherence and prevent CRN.
journal_name
Med Carejournal_title
Medical careauthors
McElfish PA,Long CR,Payakachat N,Felix H,Bursac Z,Rowland B,Hudson JS,Narcisse MRdoi
10.1097/MLR.0000000000000887subject
Has Abstractpub_date
2018-04-01 00:00:00pages
341-349issue
4eissn
0025-7079issn
1537-1948journal_volume
56pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes. OBJECTIVE:To identify and categorize physically injured trauma survivors' posttraumatic concerns. RESEARCH DE...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200104000-00004
更新日期:2001-04-01 00:00:00
abstract::The association of underutilization of drugs prescribed for the treatment of hypertension and acute-care hospital readmissions was evaluated. The data base consisted of computerized hospitalization records and computerized out-patient pharmacy records, checked by chart audit for validity. The number of days' supply of...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198912000-00007
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Physician and patient gender both influence medical communication. Nonverbal behavior is generally under-researched in the medical encounter but plays an important role for patient outcomes such as satisfaction. OBJECTIVE:This article aims at identifying how specific physician nonverbal behaviors predict an...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31817e1877
更新日期:2008-12-01 00:00:00
abstract::Even with the passage of state safety belt laws, primary care physicians can contribute to their patients' safety by brief interventions. The present study explores the prevalence of such action with adult patients and tests the power of constructs taken from social learning theory to explain physicians' behavior. The...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198804000-00006
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVES:The effectiveness of case-managed residential care (CMRC) in reducing substance abuse, increasing employment, decreasing homelessness, and improving health was examined. METHODS:A five-year prospective experiment included 358 homeless addicted male veterans 3, 6, and 9 months during their enrollment and at ...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-199801000-00006
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Administrative databases are increasingly being used to study the incident dialysis population and have important advantages. However, traditional methods of risk adjustment have limitations in this patient population. OBJECTIVE:Our objective was to develop a prognostic index for 1-year mortality in inciden...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318202aa0b
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:The practice of ordering "Do-Not-Resuscitate" (DNR) varies across hospitals. No research has explored how the DNR variation would affect cross-institutional performance reporting when DNR status is used as a risk adjustor. OBJECTIVE:We sought to assess the impact of DNR variation on performance reporting. ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000167106.09265.4e
更新日期:2005-07-01 00:00:00
abstract::While Preferred Provider Organizations (PPOs) are designed to contain the costs of health care, they may not be able to do so if sicker individuals opt not to use PPO providers. This study examined how level of mental health status and prior use of mental health services affected the decision to use or not use PPO pro...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199109000-00011
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:To investigate differences in self-rated health (SRH) between web and mail questionnaires in a mixed mode survey and to provide a model that explains those differences. SUBJECTS:A total of 15,200 mail respondents and 17,829 web respondents from the 2008 US National Health Survey conducted by the Gallup Panel...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31829a4f92
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The quality of nursing home (NH) care for residents with advanced dementia has been described as suboptimal. One relatively understudied factor in the provision of NH care is the role of private oversight and monitoring by family members and friends. OBJECTIVE:To examine the association between private over...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318195fce7
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Social determinants of health (SDH) data collected in health care settings could have important applications for clinical decision-making, population health strategies, and the design of performance-based incentives and penalties. One source for cataloging SDH data is the International Statistical Classifica...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000764
更新日期:2017-09-01 00:00:00
abstract::A population-based approach was used to analyze the utilization patterns of hospital care by Manitoba residents during the fiscal year 1991/1992. Patterns were analyzed for eight administrative regions, with use assigned to the patient's region of residence, regardless of the location of the hospitalization. Regional ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199512001-00008
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:In response to the growing concern about healthcare-associated infections (HAIs), US Department of Health and Human Services (HHS) developed the National Action Plan to Prevent Healthcare-associated Infections. A key focus of the Action Plan is the setting of HAI metrics and targets and the enhancement and d...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000027
更新日期:2014-02-01 00:00:00
abstract::An expository account of multiple time series analysis is presented. Modeling several related time series together makes it possible to ascertain dynamic leading, lagging, and feedback relationships among the series; to produce more efficient forecasts and, in some situations; to develop control schemes. Procedures fo...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:High opioid dosage has been associated with overdose, and clinical guidelines have cautioned against escalating dosages above 100 morphine-equivalent mg (MEM) based on the potential harm and the absence of evidence of benefit from high dosages. However, this 100 MEM threshold was chosen somewhat arbitrarily....
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000505
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Accurate estimation of medical care costs raises a host of issues, both practical and methodological. OBJECTIVES:This article reviews methods for estimating the long-term medical care costs associated with a cancer diagnosis. METHODS:The authors consider data from administrative claims databases and descri...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The Agency for Healthcare Research and Quality (AHRQ) developed 20 patient safety indicators (PSIs) to identify potentially preventable complications of acute inpatient care based on administrative data. The objective of this patient safety performance study was to assess the impact of cases flagged by each P...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31815f537f
更新日期:2008-05-01 00:00:00
abstract::In this study, changes in the number, site, and source of follow-up visits and allowed charges were examined for follow-up visits provided to Medicare surgical patients between 1984 and 1986. Among the 21 surgical procedures studied, follow-up visits decreased by 5.2%, after adjusting for case mix. Despite the physici...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199303000-00005
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Several organizations are advocating for patients' preferences to be considered in clinical practice guideline development and implementation. However, lack of agreement on the goal and meaning of this policy curtails evaluation and development of patient involvement programs. GOAL:To describe guideline dev...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181a81158
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between estimated travel time to admitting hospital and mortality for veterans with acute ischemic stroke, controlling for patient demographic, clinical, facility-level variables, as well as select in-hospital treatments and procedures. METHODS:A longitudinal observational populat...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000366
更新日期:2015-06-01 00:00:00
abstract::In recent years, employers, insurers, and government purchasers have paid increased attention to the measurement of patient outcomes and health status. Such interest is stimulated less by policy or quality concerns than by the need to reduce health care expenditures. Any expected benefits which might accrue from healt...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199205001-00006
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Population-based cancer registries represent a potentially valuable tool to evaluate treatment; however, information on the completeness of registry treatment data is sparse. OBJECTIVE:To evaluate the completeness of registry treatment data for patients with colorectal cancer and to identify predictors of c...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000083740.12949.88
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:This study was the first of its kind to evaluate and compare the quality of private and public community health centers (CHCs) in urban China. METHODS:A total of 2501 CHCs in 35 cities were chosen in 2011 using a multistage sampling method, and data on human resources, medical equipment and drug inventory w...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000414
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Although there are several studies of the human and system factors that influence the outcomes of cardiac surgery, it remains difficult to draw conclusions because many do not simultaneously adjust for the characteristics of patients, physicians, and institutions. The current study explores the associations ...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e3182a048af
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Black prostate cancer patients are less likely to receive aggressive therapy (AT) than Whites: reported rates for patients ≥ 65 years old are about 55% versus 65%. Little is known about treatment rates in socioeconomically deprived states with large Black populations like Alabama. STUDY DESIGN:Medicare clai...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181eb31a8
更新日期:2010-10-01 00:00:00
abstract::The published preferences for scale steps in a health-related quality-of-life scale have been noted to be contrary to some prior assumptions about their rank ordering. The differences noted are actually statistically nonsignificant, and the observed ordering has a clear intuitive explanation. Several alternative expla...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198205000-00008
更新日期:1982-05-01 00:00:00
abstract::The evaluation of long-term care demonstrations has to deal with complex organizational entities, with large, heterogeneous client populations that, during the course of study, may have to change features of their organization or operation. The implications of such "real-time" changes are discussed for analyses of the...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199512000-00004
更新日期:1995-12-01 00:00:00
abstract::The increased demand for health status measures in evaluating medical interventions has increased the importance of clarifying when to use generic versus disease-specific health status measures. The authors compared the performance of a well known generic health status measure, the Sickness Impact Profile (SIP), and a...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::Patterns of primary health care utilization for a random sample of urban elementary school children in three ethnic groups are described. Visit type, reasons for visit, and frequency of visits remained stable from year to year. More than 50 per cent of the children were non-visitors each year; 72 per cent of those not...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198106000-00003
更新日期:1981-06-01 00:00:00
abstract::The desired form and style of written drug information for patients were assessed in a national survey of oral contraceptive (OC) users. These women were queried about two forms of OC information: a short insert included with dispensed drugs and a longer brochure delivered by the physician upon patient request. Longer...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197812000-00008
更新日期:1978-12-01 00:00:00