Winters Karen P, Wyatt Sharon B, Nick Todd G, Hewlett Peggy O, Hyde John C, Fletcher Audwin B
School of Nursing, University of Mississippi Medical Center, Jackson, MS 39216, USA.
ABNF J. 2010 Winter;21(1):21-6.
To determine the effects of health insurance and race on prescription medication use and expense.
An observational, non-experimental design was used. Multivariable regression analyses were conducted to evaluate the independent effects of health insurance status and race on prescription medication use and expense while controlling for sociodemographic, geographic, and health status characteristics. The sample consisted of 19,035 participants in the 1996 through 2003 Medical Expenditure Panel Survey.
European Americans spent about $300 to $400 more and used three to four more prescriptions annually compared to other racial groups. Prescription medication expenses increased as time spent uninsured increased. Participants with part-year coverage filled four fewer prescriptions than those with full-year health insurance coverage. Participants with private coverage spent less on prescription medications compared to those with public and those with dual public and private coverage ($1,194 vs. $1,931 and $2,076, respectively; p < or = 0.001).
Significant racial and health insurance status disparities in prescription medication use and expenses exist after controlling for sociodemographic, geographic, and health status characteristics.
确定医疗保险和种族对处方药使用及费用的影响。
采用观察性、非实验性设计。进行多变量回归分析,以评估医疗保险状况和种族在控制社会人口统计学、地理和健康状况特征的情况下对处方药使用及费用的独立影响。样本包括1996年至2003年医疗支出小组调查中的19,035名参与者。
与其他种族群体相比,欧裔美国人每年在处方药上的花费多约300至400美元,且多使用三到四种处方药。随着未参保时间的增加,处方药费用增加。部分年份参保的参与者比全年参保的参与者少开四种处方药。与有公共保险以及有公共和私人双重保险的参与者相比,有私人保险的参与者在处方药上的花费更少(分别为1,194美元、1,931美元和2,076美元;p≤0.001)。
在控制社会人口统计学、地理和健康状况特征后,处方药使用和费用方面存在显著的种族和医疗保险状况差异。