Bakk Louanne
J Health Care Poor Underserved. 2015 Nov;26(4):1132-48. doi: 10.1353/hpu.2015.0113.
Little is known about whether racial and ethnic disparities in cost-related medication nonadherence (CRN) have changed since the implementation of Medicare Part D. This longitudinal study examined the impact of Part D on CRN among racial and ethnic minority Medicare beneficiaries, age 65 and older. Nationally representative data were obtained from the Prescription Drug Study and Health and Retirement Study. A differences-in-differences approach was used to compare CRN among non-Hispanic Blacks, Hispanics, and non-Hispanic Whites. The results indicate CRN was higher among the two minority groups than among non-Hispanic Whites before and after Medicare Part D. Mixed-effects logistic regression analyses show that CRN did not significantly change between pre- and post-Medicare Part D for any of these three groups. However, older non-Hispanic Blacks and Hispanics had a larger reduction in CRN than non-Hispanic Whites. These findings suggest that despite Medicare Part D, racial and ethnic disparities in CRN persist.
自医疗保险D部分实施以来，与费用相关的药物治疗不依从性（CRN）方面的种族和族裔差异是否发生变化，目前所知甚少。这项纵向研究调查了医疗保险D部分对65岁及以上种族和族裔少数医疗保险受益人的CRN的影响。全国代表性数据来自处方药研究和健康与退休研究。采用差异中的差异方法来比较非西班牙裔黑人、西班牙裔和非西班牙裔白人之间的CRN。结果表明，在医疗保险D部分实施之前和之后，两个少数群体中的CRN均高于非西班牙裔白人。混合效应逻辑回归分析表明，这三组人群在医疗保险D部分实施前后，CRN均无显著变化。然而，年龄较大的非西班牙裔黑人和西班牙裔在CRN方面的降幅比非西班牙裔白人更大。这些发现表明，尽管有医疗保险D部分，但CRN方面的种族和族裔差异依然存在。
