National Healthcare Quality and Disparities Report
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- Access to Care (2)
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- Health Services Research (HSR) (1)
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- (-) Low-Income (11)
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- (-) Medication (11)
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- Patient Adherence/Compliance (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedJazowski SA, Samuel-Ryals CA, Wood WA
Association between low-income subsidies and inequities in orally administered antimyeloma therapy use.
This study’s goal was to determine the association between low-income subsidies and inequities in orally administered antimyeloma therapy use. This retrospective cohort study used Surveillance, Epidemiology, and End Results-Medicare data to identify beneficiaries diagnosed with multiple myeloma between 2007 and 2015. The authors examined therapy initiation in the 30, 60, and 90 days following diagnosis and adherence to and discontinuation of treatment in the 180 days following initiation. They found that receipt of full subsidies was not associated with earlier initiation of or improved adherence to orally administered antimyeloma therapy. Full-subsidy enrollees were 22% more likely to experience earlier treatment discontinuation than nonsubsidy enrollees. Black full-subsidy and nonsubsidy enrollees were 14% less likely than their White counterparts to ever initiate treatment.
AHRQ-funded; HS026122.
Citation: Jazowski SA, Samuel-Ryals CA, Wood WA .
Association between low-income subsidies and inequities in orally administered antimyeloma therapy use.
Am J Manag Care 2023 May; 29(5):246-54. doi: 10.37765/ajmc.2023.89357..
Keywords: Healthcare Costs, Medication, Low-Income
Glynn A, Hernandez I, Roberts ET
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
This study’s objective was to estimate the take-up of the Medicare Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes and examine differences in out-of-pocket costs and prescription drug use between LIS enrollees and LIS-eligible non-enrollees. Data from the Health and Retirement Study linked to Medicare administrative data from 2008 to 2016 was used. The authors first estimated LIS take-up stratified by income (≤100% of the Federal Poverty Level [FPL] and >100% to ≤150% of FPL). Second, to assess the consequences of forgoing the LIS among near-poor beneficiaries (incomes >100% to ≤150% of FPL), they conducted propensity score-weighted regression analyses to compare out-of-pocket costs, prescription drug use, and cost-related medication non-adherence among LIS enrollees and LIS-eligible non-enrollees. Among Medicare beneficiaries with diabetes, 68.1% of those considered near-poor (incomes >100% to ≤150% of FPL) received the LIS, compared to 90.3% of those with incomes ≤100% of FPL. Among near-poor beneficiaries, LIS-eligible non-enrollees incurred higher annual out-of-pocket drug spending ($518], filled 7.3 fewer prescriptions for diabetes, hypertension, and hyperlipidemia drugs, and were 8.9 percentage points more likely to report skipping drugs due to cost. all compared to LIS enrollees.
AHRQ-funded; HS026727.
Citation: Glynn A, Hernandez I, Roberts ET .
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
Health Serv Res 2022 Oct;57(5):1136-44. doi: 10.1111/1475-6773.13990..
Keywords: Medication, Diabetes, Chronic Conditions, Low-Income, Medicare, Healthcare Costs
Roberts ET, Glynn A, Donohue JM
The relationship between take-up of prescription drug subsidies and Medicaid among low-income Medicare beneficiaries.
In this study, the investigators examined take-up of the Low-Income Subsidy (LIS) and Medicaid among Medicare beneficiaries who qualified for both programs. They went beyond prior analyses that reported average enrollment by program by 1.) examining whether LIS take-up mirrored Medicaid enrollment at income levels where individuals qualified for limited Medicaid benefits that had low take-up rates and 2.) highlighting opportunities for policy reforms to increase participation in both programs.
AHRQ-funded; HS026727.
Citation: Roberts ET, Glynn A, Donohue JM .
The relationship between take-up of prescription drug subsidies and Medicaid among low-income Medicare beneficiaries.
J Gen Intern Med 2021 Sep;36(9):2873-76. doi: 10.1007/s11606-020-06241-y..
Keywords: Medicaid, Medicare, Medication, Low-Income, Health Insurance
Hill LM, Lightfoot AF, Riggins L
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
The authors conducted a venue-based community survey with 53 African American women living in low-income neighborhoods of a Southeastern city in order to understand women's knowledge of and attitudes toward pre-exposure prophylaxis (PrEP). They found that awareness of PrEP was very low, with only 16% being aware that PrEP is used for HIV prevention. The vast majority reported that they would use or would consider using PrEP, most frequently citing a general interest in HIV prevention or a lack of awareness of their partners' HIV status as motivations for their interest. Some women expressed concerns about side effects or low perceived HIV risk as disincentives for PrEP use.
AHRQ-funded; HS000032.
Citation: Hill LM, Lightfoot AF, Riggins L .
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
AIDS Care 2021 Feb;33(2):239-43. doi: 10.1080/09540121.2020.1769834..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Women, Low-Income, Prevention, Medication
McCoy RG, Van Houten HK, Deng Y
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
Investigators sought to compare trends in initiation of treatment with GLP-1RA, SGLT2i, and DPP-4i by older adults with type 2 diabetes insured by Medicare Advantage vs commercial health plans. They found that Medicare Advantage beneficiaries may be less likely than commercially insured beneficiaries to be treated with newer medications to lower glucose levels, with greater disparities among lower-income patients. They recommended further investigation of nonclinical factors contributing to treatment decisions and efforts to promote greater equity in diabetes management.
AHRQ-funded; HS025164.
Citation: McCoy RG, Van Houten HK, Deng Y .
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
JAMA Netw Open 2021 Feb;4(2):e2035792. doi: 10.1001/jamanetworkopen.2020.35792..
Keywords: Elderly, Diabetes, Chronic Conditions, Medication, Medicare, Health Insurance, Disparities, Low-Income
McManus KA, Debolt C, Elwood S
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
This study examined low-income HIV patients’ perspective on the Virginia AIDS Drug Assistance Program (ADAP) Affordable Care Act (ACA) implementation. Patients were recruited at three HIV clinics in Virginia with the goal of enrolling greater than 5% of those who were eligible for the Qualified Health Plan (QHP). The recruitment goals were met with 53 patients enrolled. Two-thirds of patients were recruited to the QHP via case managers and social workers at the HIV clinics. Concerns about privacy using the mail-order pharmacy was the biggest barrier with 9 out of 10 participants. Otherwise, most participants had positive perceptions of the QHP.
AHRQ-funded; HS024196.
Citation: McManus KA, Debolt C, Elwood S .
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
AIDS Res Hum Retroviruses 2019 Aug;35(8):734-45. doi: 10.1089/aid.2018.0254..
Keywords: Human Immunodeficiency Virus (HIV), Access to Care, Medication, Low-Income, Vulnerable Populations
Ghosh A, Simon K, Sommers BD
The effect of health insurance on prescription drug use among low-income adults: evidence from recent Medicaid expansions.
This study examined how subsidized coverage affected prescription drug utilization among low-income non-elderly adults. Among other results, the investigators found that within the first 15 months of new health insurance availability, aggregate Medicaid-paid prescriptions increased 19 percent, amounting to nearly 9 new prescriptions a year, per new enrollee. They also found no evidence of reductions in uninsured or privately-insured prescriptions, suggesting that new coverage did not simply substitute for other payment sources.
AHRQ-funded; HS021291.
Citation: Ghosh A, Simon K, Sommers BD .
The effect of health insurance on prescription drug use among low-income adults: evidence from recent Medicaid expansions.
J Health Econ 2019 Jan;63:64-80. doi: 10.1016/j.jhealeco.2018.11.002..
Keywords: Health Insurance, Healthcare Utilization, Low-Income, Medicaid, Medication
Mueller LE, Haidari LA, Wateska AR
The impact of implementing a demand forecasting system into a low-income country's supply chain.
The authors evaluated the potential impact and value of applications of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas. They used their HERMES software to study Niger's entire vaccine supply chain and found that demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose, when implemented with storage and transportation increases.
AHRQ-funded; HS023317.
Citation: Mueller LE, Haidari LA, Wateska AR .
The impact of implementing a demand forecasting system into a low-income country's supply chain.
Vaccine 2016 Jul 12;34(32):3663-9. doi: 10.1016/j.vaccine.2016.05.027.
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Keywords: Access to Care, Health Services Research (HSR), Low-Income, Medication, Vaccination
Osborn CY, Mayberry LS, Kim JM
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
The authors sought to identify which behaviors are most important for HbA1c among low-socioeconomic status patients with type 2 diabetes mellitus. They found that only medication adherence was significantly associated with lower HbA1c after adjusting for the other self-care behaviours and further adjusting for demographic and diabetes characteristics. They suggested that focused efforts to improve medication adherence among low-socioeconomic status patient populations may improve glycemic control.
AHRQ-funded; HS022990.
Citation: Osborn CY, Mayberry LS, Kim JM .
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
J Clin Pharm Ther 2016 Jun;41(3):256-9. doi: 10.1111/jcpt.12360.
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Keywords: Diabetes, Low-Income, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Ratanawongsa N, Karter AJ, Quan J
Reach and validity of an objective medication adherence measure among safety net health plan members with diabetes: a cross-sectional study.
The objective of this study was to evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. It concluded that CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable with its performance in studies among other insured populations.
AHRQ-funded; HS020684; HS022561; HS017261.
Citation: Ratanawongsa N, Karter AJ, Quan J .
Reach and validity of an objective medication adherence measure among safety net health plan members with diabetes: a cross-sectional study.
J Manag Care Spec Pharm 2015 Aug;21(8):688-98. doi: 10.18553/jmcp.2015.21.8.688..
Keywords: Diabetes, Patient Adherence/Compliance, Patient Self-Management, Medication, Low-Income
Zhang Y, Zhou C, Baik SH
A simple change to the Medicare Part D low-income subsidy program could save $5 billion.
The authors used an intelligent reassignment algorithm and 2008-09 Medicare Part D drug use and spending data to match enrollees to available Part D plans according to their medication needs. They found that such a reassignment approach, compared to the current approach, could have saved the federal government over $5 billion in 2009.
AHRQ-funded; HS018657.
Citation: Zhang Y, Zhou C, Baik SH .
A simple change to the Medicare Part D low-income subsidy program could save $5 billion.
Health Aff 2014 Jun;33(6):940-5. doi: 10.1377/hlthaff.2013.1083.
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Keywords: Healthcare Costs, Low-Income, Medicare, Medication