Document Detail


The effects of cost-sharing on essential drug prescriptions, utilization of medical care and outcomes after acute myocardial infarction in elderly patients.
MedLine Citation:
PMID:  12186169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: After a change in Quebec's policy on drug coverage in August 1996, elderly patients' copayments for prescription drugs increased. We assessed the impact of this drug policy reform on prescribing patterns for essential cardiac medications, utilization of medical care and related health outcomes after acute myocardial infarction.
METHODS: Patients at least 65 years of age who experienced acute myocardial infarction between 1994 and 1998 were identified through the Quebec discharge summary database. Drug claims databases were analyzed to determine rates of prescription of essential cardiac medications for cohorts of patients admitted before and after the policy reform. The impact on readmissions for cardiac-related complications, outpatient visits to physicians and emergency departments, and mortality rate was also assessed.
RESULTS: The proportion of patients who received prescriptions for beta-blockers, angiotensin-converting enzyme inhibitors and lipid-lowering drugs increased over time and, more specifically, did not appear to decline with the change in the drug policy. In addition, the policy reform did not appear to affect persistence of drug therapy (the proportion of time for which patients were covered by prescriptions over the year after discharge). There was no within-class shift from more to less expensive drugs. Use of cardiac procedures increased over time, but this increase was unrelated to the date of the policy reform. Finally, rates of readmission for complications, visits to individual physicians and to emergency departments, and mortality rate were unchanged. The findings did not vary with sex or socioeconomic status.
INTERPRETATION: Prescriptions for essential cardiac medications and care related to acute myocardial infarction in elderly patients did not change with increases in out-of-pocket copayment, regardless of sex or socioeconomic status.
Authors:
Louise Pilote; Christine Beck; Hugues Richard; Mark J Eisenberg
Related Documents :
15154829 - Current requirements and emerging trends for labelling as a tool for communicating phar...
18023249 - Is the gap between guidelines and clinical practice in heart failure treatment being fi...
8829029 - Outpatient prescription drug use by children enrolled in five drug benefit plans.
20227199 - Prescription drugs purchased through the internet: who are the end users?
15114069 - Recognize the role of employers.
11208289 - Pattern of drug use amongst antenatal patients in benin city, nigeria.
19645639 - Understanding australia's influenza pandemic policy on the strategic use of the antivir...
17052679 - Screening for transient biological interactions as applied to albumin ligands: a new co...
3729679 - Effects of nifedipine on cell resistance and cardiac toxicity--in vitro and in vivo exp...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  167     ISSN:  0820-3946     ISO Abbreviation:  CMAJ     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-20     Completed Date:  2002-08-27     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  246-52     Citation Subset:  AIM; IM    
Affiliation:
Division of Internal Medicine, Montreal General Hospital Research Institute, Que. louise.pilote@mcgill.ca
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / economics,  therapeutic use
Age Factors
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors / economics,  therapeutic use
Cost Sharing*
Costs and Cost Analysis
Databases, Factual
Drug Prescriptions / economics*
Female
Health Care Reform
Health Policy
Health Services / utilization*
Humans
Hypolipidemic Agents / economics,  therapeutic use
Insurance Coverage
Male
Myocardial Infarction / drug therapy*,  economics*
Quebec
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Hypolipidemic Agents
Comments/Corrections

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


Previous Document:  Incidence of open neural tube defects in Nova Scotia after folic acid fortification.
Next Document:  Medical genetics: 1. Clinical teratology in the age of genomics.