| Titre : | Exhaustion of drug benefits and disenrollment of medicare beneficiaries from managed care organizations. (2000) |
| Auteurs : | T.S. RECTOR |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 283, n° 16, 2000) |
| Pagination : | 2163-2167 |
| Langues: | Anglais |
| Mots-clés : | Thérapeutique médicamenteuse ; Thérapeutique ; Soins santé primaire ; Analyse coût avantage ; Homme |
| Résumé : | [BDSP. Notice produite par INIST PoSz9R0x. Diffusion soumise à autorisation]. Context Many Medicare beneficiaries enroll in managed care health plans to obtain outpatient drug benefits. Increasing pharmaceutical utilization and costs and decreasing drug benefits increase the likelihood that medication use by such enrollees will exceed drug benefits, which may lead to health plan disenrollment. Objective To test the hypothesis that exhaustion of managed care drug benefits by Medicare beneficiaries is associated with disenrollment from the health plan. Design Retrospective cohort study followed up for 1 year (1998) using an enrollment/claims database. Setting Four geographically diverse network-model health plans that had annual drug benefits of $300, $500, $600, or $1000. Participants A total of 61412 elderly Medicare beneficiaries. Main Outcome Measure Voluntary disenrollment from health plans by members who did or did not exhaust their drug benefits. Results The likelihood of exhausting 1998 drug benefits ranged from 17% to 25% across health plans (P<. 001). The relative hazards of disenrollment from the 4 plans when drug benefits had been exhausted were 2.5 (95% confidence interval [CI], 2.3-2.8), 1.9 (95% Cl, 1.7-2.1), 2.7 (95% Cl, 2.0-3.6), and 2.1 (95% Cl, 1.9-2.4). Statistical adjustments for age, sex, prior enrollment, hospital admissions, physician visits, and county of residence did not alter these estimates. (...) |
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