Cline Richard R, Gupta Kiran
College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA.
Res Social Adm Pharm. 2005 Mar;1(1):5-20. doi: 10.1016/j.sapharm.2004.12.004.
The Medicare Prescription Drug, Improvement and Modernization Act of 2003 will provide drug coverage to older adults through a variety of mechanisms, including stand-alone prescription drug benefits. Variation in cost-sharing and utilization controls is permitted, leading potentially to a wide variety of prescription benefit plans. However, little is known regarding the manner in which beneficiaries will integrate information to form plan evaluations.
The objectives of this study were to assess and compare the use of compensatory and configural judgment models in older adults' evaluations of drug benefit plans.
Three focus groups were conducted with a total of 19 seniors to elicit relevant drug plan attributes. A separate group of 32 seniors then judged the suitability of 48 drug benefit profiles based on these attributes. Within-subjects regression analysis was used to reveal each participant's judgment policy.
Focus groups suggested that copayment, premium, deductible, formulary use, and mail-service use were relevant plan attributes. Regression analyses showed that while most participants used compensatory judgment models in evaluation formation, 12 (37.5%) subjects used conjunctive judgment models.
Configural judgment processes are used frequently by older adults when evaluating drug benefit plans. Future research using more fine-grained techniques (eg, process tracing) might help further elucidate judgment processes in this context.
2003年的《医疗保险处方药、改进与现代化法案》将通过多种机制为老年人提供药物保险，包括独立的处方药福利。成本分摊和使用控制方面存在差异，这可能导致各种各样的处方药福利计划。然而，对于受益人将如何整合信息以形成计划评估，我们知之甚少。
本研究的目的是评估和比较补偿性和构型判断模型在老年人对药物福利计划评估中的应用。
对总共19名老年人进行了三个焦点小组访谈，以引出相关的药物计划属性。然后，另一组32名老年人根据这些属性判断48种药物福利概况的适用性。采用受试者内回归分析来揭示每个参与者的判断策略。
焦点小组表明，自付费用、保费、免赔额、处方集使用和邮寄服务使用是相关的计划属性。回归分析表明，虽然大多数参与者在评估形成过程中使用补偿性判断模型，但有12名（37.5%）受试者使用了联合判断模型。
老年人在评估药物福利计划时经常使用构型判断过程。未来使用更精细技术（如过程追踪）的研究可能有助于进一步阐明这一背景下的判断过程。
