患者费用分担趋势如何影响依从性和治疗结果：一项文献综述。
How patient cost-sharing trends affect adherence and outcomes: a literature review.
作者信息
Eaddy Michael T, Cook Christopher L, O'Day Ken, Burch Steven P, Cantrell C Ron
出版信息
P T. 2012 Jan;37(1):45-55.
OBJECTIVE
We sought to assess the relationship between patient cost sharing; medication adherence; and clinical, utilization, and economic outcomes.
METHODOLOGY
We conducted a literature review of articles and abstracts published from January 1974 to May 2008. Articles were identified using PubMed, Ovid, medline, Web of Science, and Google Scholar databases. The following terms were used in the search: adherence, compliance, copay, cost sharing, costs, noncompliance, outcomes, hospitalization, utilization, economics, income, and persistence.
RESULTS
We identified and included 160 articles in the review. Although the types of interventions, measures, and populations studied varied widely, we were able to identify relatively clear relationships between cost sharing, adherence, and outcomes. Of the articles that evaluated the relationship between changes in cost sharing and adherence, 85% showed that an increasing patient share of medication costs was significantly associated with a decrease in adherence. For articles that investigated the relationship between adherence and outcomes, the majority noted that increased adherence was associated with a statistically significant improvement in outcomes.
CONCLUSION
Increasing patient cost sharing was associated with declines in medication adherence, which in turn was associated with poorer health outcomes.
目的
我们试图评估患者费用分担、药物依从性以及临床、使用情况和经济结果之间的关系。
方法
我们对1974年1月至2008年5月发表的文章和摘要进行了文献综述。使用PubMed、Ovid、medline、科学网和谷歌学术数据库来识别文章。搜索中使用了以下术语：依从性、顺应性、自付费用、费用分担、成本、不依从、结果、住院、使用情况、经济学、收入和持续性。
结果
我们在综述中识别并纳入了160篇文章。尽管所研究的干预措施、测量方法和人群类型差异很大，但我们能够确定费用分担、依从性和结果之间相对明确的关系。在评估费用分担变化与依从性之间关系的文章中，85%表明患者药物费用份额增加与依从性下降显著相关。对于研究依从性与结果之间关系的文章，大多数指出依从性提高与结果在统计学上的显著改善相关。
结论
患者费用分担增加与药物依从性下降相关，而药物依从性下降又与较差的健康结果相关。
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