Dataset Information

The impact of Medicare Part D on hospitalization rates.

ABSTRACT:

Objective

To determine whether the change in prescription drug insurance coverage associated with Medicare Part D reduced hospitalization rates for conditions sensitive to drug adherence.

Data sources/study setting

Hospital discharge data from 2005 to 2007 for 23 states, linked with state-level data on drug coverage.

Study design

We use a difference-in-difference-in-differences approach, comparing changes in the probability of hospitalization before and after the introduction of the Part D benefit in 2006, for individuals aged 65 and older (versus individuals aged 60-64) in states with low drug coverage in 2005 (versus those in states with high pre-Part D drug coverage).

Data collection/extraction methods

Hospitalization rates for selected ambulatory care sensitive conditions in 23 states were computed using data from the Census and Health Care Utilization Project. Drug coverage rates were computed using data from several sources.

Principal findings

For the conditions studied, our point estimates suggest that Part D reduced the overall rate of hospitalization by 20.5 per 10,000 (4.1 percent), representing approximately 42,000 admissions, about half of the reduction in admissions over our study period. Conclusions. The increase in drug coverage associated with Medicare Part D had positive effects on the health of elderly Americans, which reduced use of nondrug health care resources.

SUBMITTER: Afendulis CC

PROVIDER: S-EPMC3165176 | biostudies-literature | 2011 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The impact of Medicare Part D on hospitalization rates.

Afendulis Christopher C CC He Yulei Y Zaslavsky Alan M AM Chernew Michael E ME

Health services research 20110209 4

<h4>Objective</h4>To determine whether the change in prescription drug insurance coverage associated with Medicare Part D reduced hospitalization rates for conditions sensitive to drug adherence.<h4>Data sources/study setting</h4>Hospital discharge data from 2005 to 2007 for 23 states, linked with state-level data on drug coverage.<h4>Study design</h4>We use a difference-in-difference-in-differences approach, comparing changes in the probability of hospitalization before and after the introducti ...[more]

PMID: 21306369

Similar Datasets

Project description:BackgroundIncome-related inequality measures such as the concentration index are often used to describe the unequal distribution of health, health care access, or expenditure in a single measure. This study demonstrates the use of such measures to evaluate the distributional impact of changes in health insurance coverage. We use the example of Medicare Part D in the United States, which increased access to prescription medications for Medicare beneficiaries from 2006.MethodsUsing pooled cross-sectional samples from the Medical Expenditure Panel Survey for 1997-2011, we estimated income-related inequality in drug expenditures over time using the concentration and generalised concentration indices. A difference-in-differences analysis investigated the change in inequality in drug expenditures, as measured using the concentration index and generalised concentration index, between the elderly (over 65 years) and near-elderly (54-63 years) pre- and post-implementation of Medicare Part D.ResultsMedicare Part D increased public drug expenditure while out-of-pocket and private spending fell. Public drug expenditures favoured the poor during all study periods, but the degree of pro-poorness declined in the years immediately following the implementation of Part D, with the poor gaining less than the rich in both relative and absolute terms. Part D also appeared to result in a fall in the pro-richness of private insurance drug expenditure in absolute terms but have minimal distributional impact on out-of-pocket expenditure. These effects appeared to be short lived, with a return to the prevailing trends in both concentration and generalised concentration indices several years following the start of Part D.ConclusionsThe implementation of Medicare Part D significantly reduced the degree of pro-poorness in public drug expenditure. The poor gained less of the increased public drug expenditure than the rich in both relative and absolute terms. This study demonstrates how income-related inequality measures can be used to estimate the impact of health system changes on inequalities in health expenditure and provides a guide for future evaluations.

Dataset Information

The impact of Medicare Part D on hospitalization rates.

Objective

Data sources/study setting

Study design

Data collection/extraction methods

Principal findings

Publications

The impact of Medicare Part D on hospitalization rates.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets