Résumé :
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[BDSP. Notice produite par INIST-CNRS jR0xEOdN. Diffusion soumise à autorisation]. Context Cost-sharing in US prescription drug coverage plans for elderly persons varies widely. Evaluation of prescription drug use among elderly persons by type of health insurance could provide useful information for designing a Medicare drug program. Objective To determine use of effective cardiovascular drugs among elderly persons with coronary heart disease (CHD) by type of health insurance. Design, Setting, and Patients Cross-sectional evaluation of 1908 community-dwelling adults, aged 66 years or older, with a history of CHD or myocardial infarction from the 1997 Medicare Current Beneficiary Survey, a nationally representative sample of Medicare beneficiaries. Main Outcome Measures Use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), bêta-blockers, and nitrates, and out-of-pocket expenditures for prescription drugs, stratified by type of health insurance : Medicare without drug coverage (Medicare only or self-purchased supplemental insurance) or with drug coverage (Medicaid, other public program, Medigap, health maintenance organization, or employer-sponsored plan). Results Statin use ranged from 4.1% in Medicare patients with no drug coverage to 27.4% in patients with employer-sponsored drug coverage (P<. less variation between these types occurred for b vs p="003)" and nitrates in multivariate analyses statin use remained significantly lower patients with medicare only ratio confidence interval was medicaid cl those employer-sponsored coverage. nitrate frequently persons lacking drug coverage supplemental insurance without>
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