| Part D and dually eligible patients with mental illness: medication access problems and use of intensive services. | |
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MedLine Citation:
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PMID: 19723730 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This study examined the occurrence of medication access problems and use of intensive mental health services after the transition in January 2006 from Medicaid drug coverage to Medicare Part D for persons dually eligible for Medicaid and Medicare benefits. METHODS: Psychiatrists randomly selected from the American Medical Association's Physicians Masterfile reported on experiences of one systematically selected dually eligible patient (N=908) in the nine to 12 months after Part D implementation. Propensity score matching was used to compare use of psychiatric emergency department care and inpatient care between individuals who experienced a problem accessing a psychiatric medication after Part D and those who did not. RESULTS: Approximately 44% of dually eligible patients were reported to have experienced a problem accessing medications. The likelihood of visiting an emergency department was significantly higher for those who experienced an access problem than for those who did not (mean odds ratio=1.75, mean p=.003). There was no difference in number of emergency department visits or hospitalizations for those who had at least one. CONCLUSIONS: Many dually eligible patients had difficulty accessing psychiatric medications after implementation of Part D. These patients were significantly more likely to visit psychiatric emergency departments than patients who did not experience difficulties. These findings raise concerns about possible negative effects on quality of care. Additional study is needed to understand the full effects of Part D on outcomes and functioning as well as treatment costs for this population. |
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Authors:
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Haiden A Huskamp; Joyce C West; Donald S Rae; Maritza Rubio-Stipec; Darrel A Regier; Richard G Frank |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Psychiatric services (Washington, D.C.) Volume: 60 ISSN: 1557-9700 ISO Abbreviation: Psychiatr Serv Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-02 Completed Date: 2010-01-06 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 9502838 Medline TA: Psychiatr Serv Country: United States |
Other Details:
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Languages: eng Pagination: 1169-74 Citation Subset: IM |
Affiliation:
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Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA. huskamp@hcp.med.harvard.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Critical Care* Eligibility Determination* Female Health Care Surveys Health Services Accessibility* Humans Male Medicaid Medicare Part D* Mental Disorders / drug therapy* Middle Aged United States |
| Grant Support | |
ID/Acronym/Agency:
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1R01-MH-069721/MH/NIMH NIH HHS; K01 MH066109-01/MH/NIMH NIH HHS; K01-MH-66109/MH/NIMH NIH HHS; R01 MH069721-02/MH/NIMH NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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