Institute for Social Research, University of Michigan, Ann Arbor, USA.
J Gerontol B Psychol Sci Soc Sci. 2010 Jul;65(4):492-501. doi: 10.1093/geronb/gbp107. Epub 2009 Dec 24.
To estimate the impact of Medicare Part D on prescription drug coverage among elderly Medicare beneficiaries and to analyze the predictors of program enrollment ("take-up") among those with no prior drug coverage.
Multivariate analyses of data from the 2002, 2004, and 2006 waves of the Health and Retirement Study.
Take-up of Part D among those without drug coverage in 2004 was high; about 50%-60% of this group had Part D coverage in 2006. Only 7% of senior citizens lacked drug coverage in 2006 compared with 24% in 2004. Demand for prescription drugs was the most important determinant of the decision to enroll in Part D among those with no prior coverage. Many of those who remained without coverage in 2006 reported that they do not use prescribed medicines, and the majority had relatively low out-of-pocket spending.
For the most part, Medicare beneficiaries seem to have been able to make economically rational decisions about Part D enrollment despite the complexity of the program.
评估医疗保险部分 D 对老年医疗保险受益人的处方药覆盖范围的影响，并分析无先前药物覆盖人群参与该计划（“参与”）的预测因素。
对健康与退休研究 2002 年、2004 年和 2006 年各波次数据进行多变量分析。
2004 年无药物覆盖的人群中，参与部分 D 的比例很高；该群体中有 50%-60%的人在 2006 年获得了部分 D 的覆盖。与 2004 年的 24%相比，2006 年仅 7%的老年人缺乏药物覆盖。对于那些没有先前覆盖的人来说，对处方药的需求是决定是否参加部分 D 的最重要决定因素。2006 年仍未获得覆盖的许多人表示他们不使用处方药物，而且大多数人自付费用相对较低。
尽管该计划较为复杂，但在大多数情况下，医疗保险受益人似乎能够对部分 D 的参与做出经济理性的决策。
