Document Detail


Association between insurance gaps and continued antihypertension medication usage in a US national representative population.
MedLine Citation:
PMID:  19779465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Medication persistence is important for adequate control of blood pressure. In this article, we assess the association between gaps in insurance coverage and continued antihypertensive medication using a US national representative sample.
METHODS: We used three recent panels from the Medical Expenditure Panel Survey (MEPS). Our sample included hypertensive individuals 18-65 years of age. We identified four insurance categories: (i) continuous coverage by private insurance, (ii) continuous coverage by public insurance, (iii) single or multiple gaps in coverage, and (iv) continuously uninsured. Binary logit models were used to analyze the association between interruptions in medication and insurance after controlling for socioeconomic factors. Patients with continuous private insurance were used as the reference group. Results were weighted to adjust for oversampling and clustering in the survey.
RESULTS: There was no statistically significant difference in the probability of medication persistence between individuals with continuous private insurance (the reference group) and individuals with continuous public insurance (adjusted odds ratio (AOR) 1.324, 95% confidence interval (CI) 0.774-2.266, P = 0.304). Compared to the reference group, individuals with insurance gaps had lower odds of continuing their medication (AOR 0.636, 95% CI 0.418-0.0.969, P = 0.035). Continuously uninsured individuals had even lower odds of medication persistence (AOR 0.462, 95% CI 0.282-0.757, P = 0.002). Age, marital status, body mass index (BMI) change, and years of education were also associated with continued medication usage.
CONCLUSION: Studies focusing on current insurance status may underestimate the impact of health insurance gaps and the population at risk. Continuous insurance coverage is needed to increase continued antihypertensive medication usage.
Authors:
Yunwei Gai; Ning Yan Gu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-24
Journal Detail:
Title:  American journal of hypertension     Volume:  22     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-25     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1276-80     Citation Subset:  IM    
Affiliation:
Economics Division, Babson College, Babson Park, Massachusetts, USA. ygai@babson.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antihypertensive Agents / economics*
Female
Health Care Surveys
Health Services Accessibility
Humans
Hypertension / drug therapy*
Insurance Coverage / economics*,  statistics & numerical data*
Insurance, Health / economics*,  statistics & numerical data
Male
Medically Uninsured / statistics & numerical data
Middle Aged
National Health Programs
United States
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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