患有阿尔茨海默病和其他痴呆症的医疗保险优势计划受益人的计划转换情况。
Plan switching among Medicare Advantage beneficiaries with Alzheimer's disease and other dementias.
作者信息
Meyers David J, Rahman Momotazur, Rivera-Hernandez Maricruz, Trivedi Amal N, Mor Vincent
机构信息
Department of Health Services, Policy, and Practice Brown University School of Public Health Providence Rhode Island USA.
Center for Gerontology and Healthcare Research Brown University School of Public Health Providence Rhode Island USA.
出版信息
Alzheimers Dement (N Y). 2021 Mar 23;7(1):e12150. doi: 10.1002/trc2.12150. eCollection 2021.
INTRODUCTION
Patients with Alzheimer's disease and related dementias (ADRD) face substantial challenges in selecting, and remaining enrolled in, health insurance. Little is known about how patients with ADRD experience the Medicare Advantage (MA) program.
METHODS
We used, hospital, outpatient, and post-acute care data to identify MA beneficiaries with and without ADRD in 2014. Multinomial logit models estimated the percentage of people who disenrolled to traditional Medicare (TM) or switched to a different MA plan in 2015.
RESULTS
Among non-dually eligible beneficiaries, 9.0% (95% confidence interval [CI]: 8.0, 9.1) with ADRD disenrolled while 19.7% (95% CI: 19.6, 19.9) switched plans within MA compared to a disenrollment rate of 4.2% (95% CI: 4.2, 4.2) and switching rate of 22.8% (95% CI: 22.9, 22.8) for persons without ADRD.
DISCUSSION
MA enrollees with ADRD tend to disenroll at substantially higher rates than those without ADRD. This may be indicative of their care needs not being met in the program.
引言
阿尔茨海默病及相关痴呆症（ADRD）患者在选择和继续参保医疗保险方面面临重大挑战。对于ADRD患者如何体验医疗保险优势（MA）计划，我们知之甚少。
方法
我们利用医院、门诊和急性后护理数据，确定了2014年患有和未患有ADRD的MA受益人群。多项逻辑回归模型估计了2015年退出传统医疗保险（TM）或转而选择不同MA计划的人群比例。
结果
在非双重资格受益人群中，患有ADRD的人群中有9.0%（95%置信区间[CI]：8.0，9.1）退出，而在MA计划内转而选择其他计划的比例为19.7%（95%CI：19.6，19.9）；相比之下，未患有ADRD的人群退出率为4.2%（95%CI：4.2，4.2），转而选择其他计划的比例为22.8%（95%CI：22.9，22.8）。
讨论
患有ADRD的MA参保者退出计划的比例往往远高于未患有ADRD的参保者。这可能表明他们在该计划中的护理需求未得到满足。
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