Cromwell D M, Bass E B, Steinberg E P, Yasui Y, Ravich W J, Hendrix T R, McLeod S F, Moore R D
Department of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA.
Health Serv Res. 1999 Feb;33(6):1593-610.
To examine the impact of a policy restricting reimbursement for Medicaid anti-ulcer drugs on anti-ulcer drug use and peptic-related hospitalizations.
DATA SOURCES/STUDY SETTING: In addition to U.S. Census Bureau data, all of the following from Florida: Medicaid anti-ulcer drug claims data, 1989-1993; Medicaid eligibility data, 1989-1993; and acute care nonfederal hospital discharge abstract data (Medicaid and non-Medicaid), 1989-1993.
In this observational study, a Poisson multiple regression model was used to compare changes, after policy implementation, in Medicaid reimbursement for prescription anti-ulcer drugs as well as hospitalization rates between pre- and post-implementation periods in Medicaid versus non-Medicaid patients hospitalized with peptic ulcer disease.
Following policy implementation, the rate of Medicaid reimbursement for anti-ulcer drugs decreased 33 percent (p < .001). No associated increase occurred in the rate of Medicaid peptic-related hospitalizations.
Florida's policy restricting Medicaid reimbursement for anti-ulcer drugs was associated with a substantial reduction in outpatient anti-ulcer drug utilization without any significant increase in the rate of hospitalization for peptic-related conditions.
研究一项限制医疗补助计划（Medicaid）抗溃疡药物报销政策对该类药物使用及消化性溃疡相关住院情况的影响。
数据来源/研究背景：除美国人口普查局数据外，还使用了来自佛罗里达州的以下所有数据：1989 - 1993年医疗补助计划抗溃疡药物报销申请数据；1989 - 1993年医疗补助计划资格数据；以及1989 - 1993年急性护理非联邦医院出院摘要数据（包括医疗补助和非医疗补助患者）。
在这项观察性研究中，采用泊松多元回归模型，比较政策实施后，医疗补助计划中处方抗溃疡药物报销情况的变化，以及患有消化性溃疡疾病的医疗补助患者与非医疗补助患者在政策实施前后的住院率变化。
政策实施后，医疗补助计划中抗溃疡药物的报销率下降了33%（p <.001）。与消化性溃疡相关的医疗补助住院率没有相应增加。
佛罗里达州限制医疗补助计划抗溃疡药物报销的政策，与门诊抗溃疡药物使用率大幅下降相关，而消化性溃疡相关疾病的住院率没有显著上升。
