scholarly journals Impact of income-based deductibles on drug use and health care utilization among older adults

2017 ◽  
Vol 189 (19) ◽  
pp. E690-E696 ◽  
Author(s):  
Michael R. Law ◽  
Lucy Cheng ◽  
Heather Worthington ◽  
Muhammad Mamdani ◽  
Kimberlyn M. McGrail ◽  
...  
2006 ◽  
Vol 14 (4) ◽  
pp. 392-410 ◽  
Author(s):  
Michelle Y. Martin ◽  
M. Paige Powell ◽  
Claire Peel ◽  
Sha Zhu ◽  
Richard Allman

This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N= 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S857-S857
Author(s):  
Elizabeth A Jacobs ◽  
Rebecca Schwei ◽  
Scott Hetzel ◽  
Jane Mahoney ◽  
KyungMann Kim

Abstract The majority of older adults want to live and age in their communities. Some community-based organizations (CBOs) have initiated peer-to-peer support services to promote aging in place but the effectiveness of these programs is not clear. Our objective was to compare the effectiveness of a community-designed and implemented peer-to-peer support program vs. access to standard community services, in promoting health and wellness in vulnerable older adult populations. We partnered with three CBOs, one each in California, Florida, and New York, to enroll adults 65 > years of age who received peer support and matched control participants (on age, gender, and race/ethnicity) in an observational study. We followed participants over 12 months, collecting data on self-reported urgent care and emergency department visits and hospitalizations. In order to account for the lack of randomization, we used a propensity score method to compare outcomes between the two groups. We enrolled 222 older adults in the peer-to-peer group and 234 in the control group. After adjustment, we found no differences between the groups in the incidence of hospitalization, urgent and emergency department visits, and composite outcome of any health care utilization. The incidence of urgent care visits was statistically significantly greater in the standard community service group than in the peer-to-peer group. Given that the majority of older adults and their families want them to age in place, the question of how to do this is highly relevant. Peer-to-peer services may provide some benefit to older adults in regard to their health care utilization.


2020 ◽  
Vol 55 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Caroline A. Walsh ◽  
Caitriona Cahir ◽  
Kathleen E. Bennett

Background: The association between objectively measured nonadherence and health care utilization in multimorbid older people is unclear. Objective: To measure medication adherence across multiple chronic conditions, identify adherence patterns, and estimate the association between adherence and self-reported health care utilization. Methods: This is a retrospective cohort study of multimorbid participants aged ≥70 years in the Irish LongituDinal Study on Ageing (TILDA). Eligible participants had linked pharmacy claims data and completed TILDA wave 2 (2 years after wave 1). The RxRisk-V tool was used to identify multimorbidity. Average adherence (AA) across RxRisk-V conditions was estimated using the CMA7 function (AdhereR). Group-based trajectory models (GBTMs) identified adherence patterns in the 12 months following wave 1. Negative binomial regression was used to estimate the association between adherence and the rate of subsequent self-reported general practitioner [GP] visits, emergency department (ED) visits, outpatient visits, and hospitalizations in the 12 months following adherence measurement (reported at wave 2). Adjusted Incident Rate Ratios (aIRR) and 95% CIs are presented. Results: Higher AA (CMA7) was associated with a small significant decrease in GP visit rate (aIRR = 0.70; CI = 0.53-0.94) and outpatient visit rate (aIRR = 0.44; CI = 0.23-0.81). GBTM identified 6 adherence groups (n = 1050). Compared with high adherers, group 1 (rapid decline, modest increase) membership (aIRR = 1.72; CI = 1.09-2.73) and group 4 (high adherence, delayed decline) membership (aIRR = 1.92; CI = 1.19-3.05) significantly increased ED visit rate. Conclusion and Relevance: Suboptimal medication adherence in multimorbid older adults is associated with increased health care utilization. Identification of suboptimal adherence groups for medication management interventions may help decrease the health system burden and health care costs.


2015 ◽  
Vol 70 (11) ◽  
pp. 1442-1447 ◽  
Author(s):  
Alexander X. Lo ◽  
Kellie L. Flood ◽  
Richard E. Kennedy ◽  
Vera Bittner ◽  
Patricia Sawyer ◽  
...  

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