PDF(Pubmed)
Abstract：
UNASSIGNED: The Medicare Part D medication therapy management (MTM) program has positive effects on medication and health service utilization. However, little is known about its utilization, much less so about the use among racial and ethnic minorities.
UNASSIGNED: To examine MTM service utilization among older Medicare beneficiaries and to identify any racial and ethnic disparity patterns.
UNASSIGNED: A retrospective cross-sectional analysis of 2017 Medicare administrative data, linked to the Area Health Resources Files. Fourteen outcomes related to MTM service nature, initiation, quantity, and delivery were examined using logistic, negative binomial, and Cox proportional hazards regression models.
UNASSIGNED: Racial and ethnic disparities were found with varying patterns across outcomes. For example, compared with White patients, the odds of opting out of MTM were 8% higher for Black patients (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.03-1.14), 57% higher for Hispanic patients (OR = 1.57, 95% CI = 1.42-1.72), and 57% higher for Asian patients (OR = 1.57, 95% CI = 1.33-1.85). The odds of continuing MTM from the previous years were 12% lower for Black patients (OR = 0.88, 95% CI = 0.86-0.90) and 3% lower for other patients (OR = 0.97, 95% CI = 0.95-0.99). In addition, the probability of being offered a comprehensive medication review (CMR) after MTM enrollment was 9% lower for Hispanic patients (hazard ratio [HR] = 0.91, 95% CI = 0.85-0.97), 9% lower for Asian patients (HR = 0.91, 95% CI = 0.87-0.94), and 3% lower for other patients (HR = 0.97, 95% CI = 0.95-0.99). Hispanic and Asian patients were more likely to have someone other than themselves receive a CMR.
UNASSIGNED: Racial and ethnic disparities in MTM service utilization were identified. Although the disparities in specific utilization outcomes vary across racial/ethnic groups, it is evident that these disparities exist and may result in vulnerable communities not fully benefiting from the MTM services. Causes of the disparities should be explored to inform future reform of the Medicare Part D MTM program.
UNASSIGNED: To examine MTM service utilization among older Medicare beneficiaries and to identify any racial and ethnic disparity patterns.
UNASSIGNED: A retrospective cross-sectional analysis of 2017 Medicare administrative data, linked to the Area Health Resources Files. Fourteen outcomes related to MTM service nature, initiation, quantity, and delivery were examined using logistic, negative binomial, and Cox proportional hazards regression models.
UNASSIGNED: Racial and ethnic disparities were found with varying patterns across outcomes. For example, compared with White patients, the odds of opting out of MTM were 8% higher for Black patients (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.03-1.14), 57% higher for Hispanic patients (OR = 1.57, 95% CI = 1.42-1.72), and 57% higher for Asian patients (OR = 1.57, 95% CI = 1.33-1.85). The odds of continuing MTM from the previous years were 12% lower for Black patients (OR = 0.88, 95% CI = 0.86-0.90) and 3% lower for other patients (OR = 0.97, 95% CI = 0.95-0.99). In addition, the probability of being offered a comprehensive medication review (CMR) after MTM enrollment was 9% lower for Hispanic patients (hazard ratio [HR] = 0.91, 95% CI = 0.85-0.97), 9% lower for Asian patients (HR = 0.91, 95% CI = 0.87-0.94), and 3% lower for other patients (HR = 0.97, 95% CI = 0.95-0.99). Hispanic and Asian patients were more likely to have someone other than themselves receive a CMR.
UNASSIGNED: Racial and ethnic disparities in MTM service utilization were identified. Although the disparities in specific utilization outcomes vary across racial/ethnic groups, it is evident that these disparities exist and may result in vulnerable communities not fully benefiting from the MTM services. Causes of the disparities should be explored to inform future reform of the Medicare Part D MTM program.
摘要：
UNASSIGNED：MedicareD部分药物治疗管理（MTM）计划对药物和卫生服务利用具有积极影响。然而,对它的使用知之甚少，更不用说在种族和少数民族中的使用了。
UNASSIGNED：检查老年医疗保险受益人的MTM服务使用情况，并确定任何种族和族裔差异模式。
未经评估：对2017年医疗保险管理数据的回顾性横断面分析，链接到区域运行状况资源文件。与MTM服务性质有关的14项成果，initiation,数量,和交付使用后勤检查，负二项式，和Cox比例风险回归模型。
UNASSIGNED：发现种族和种族差异在结果之间具有不同的模式。例如,与白人患者相比，黑人患者选择退出MTM的几率高出8%(比值比[OR]=1.08,95%置信区间[CI]=1.03-1.14),西班牙裔患者高57％（OR=1.57，95％CI=1.42-1.72），亚洲患者高于57%（OR=1.57，95%CI=1.33-1.85）。过去几年中，Black患者继续进行MTM的几率降低了12％（OR=0.88，95％CI=0.86-0.90），其他患者降低了3％（OR=0.97，95％CI=0.95-0.99）。此外,西班牙裔患者在接受MTM后接受全面药物审查（CMR）的可能性降低了9％（风险比[HR]=0.91，95％CI=0.85-0.97），亚洲患者低9%(HR=0.91，95%CI=0.87-0.94)，其他患者低3%（HR=0.97，95%CI=0.95-0.99）。西班牙裔和亚裔患者更有可能让其他人接受CMR。
UNASSIGNED：确定了MTM服务利用中的种族和种族差异。尽管特定利用结果的差异因种族/族裔而异，显然，这些差异存在，可能导致脆弱社区无法充分受益于MTM服务。应探索差异的原因，以指导未来MedicareD部分MTM计划的改革。
UNASSIGNED：检查老年医疗保险受益人的MTM服务使用情况，并确定任何种族和族裔差异模式。
未经评估：对2017年医疗保险管理数据的回顾性横断面分析，链接到区域运行状况资源文件。与MTM服务性质有关的14项成果，initiation,数量,和交付使用后勤检查，负二项式，和Cox比例风险回归模型。
UNASSIGNED：发现种族和种族差异在结果之间具有不同的模式。例如,与白人患者相比，黑人患者选择退出MTM的几率高出8%(比值比[OR]=1.08,95%置信区间[CI]=1.03-1.14),西班牙裔患者高57％（OR=1.57，95％CI=1.42-1.72），亚洲患者高于57%（OR=1.57，95%CI=1.33-1.85）。过去几年中，Black患者继续进行MTM的几率降低了12％（OR=0.88，95％CI=0.86-0.90），其他患者降低了3％（OR=0.97，95％CI=0.95-0.99）。此外,西班牙裔患者在接受MTM后接受全面药物审查（CMR）的可能性降低了9％（风险比[HR]=0.91，95％CI=0.85-0.97），亚洲患者低9%(HR=0.91，95%CI=0.87-0.94)，其他患者低3%（HR=0.97，95%CI=0.95-0.99）。西班牙裔和亚裔患者更有可能让其他人接受CMR。
UNASSIGNED：确定了MTM服务利用中的种族和种族差异。尽管特定利用结果的差异因种族/族裔而异，显然，这些差异存在，可能导致脆弱社区无法充分受益于MTM服务。应探索差异的原因，以指导未来MedicareD部分MTM计划的改革。
