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Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias
The Medicare Parts C and D Star Ratings system was established to improve care quality in Medicare. Previous studies reported racial/ethnic disparities in the calculation of medication adherence measures of Star Ratings in patients with diabetes, hypertension, and hyperlipidemia. This study aimed to...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158876/ https://www.ncbi.nlm.nih.gov/pubmed/37144996 http://dx.doi.org/10.1097/MD.0000000000033641 |
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author | Tsang, Chi Chun Steve Zhang, Xiangjun Barenie, Rachel Elizabeth Cernasev, Alina Miller, Nancy A. Wan, Jim Y. Tsao, Jack W. Wang, Junling |
author_facet | Tsang, Chi Chun Steve Zhang, Xiangjun Barenie, Rachel Elizabeth Cernasev, Alina Miller, Nancy A. Wan, Jim Y. Tsao, Jack W. Wang, Junling |
author_sort | Tsang, Chi Chun Steve |
collection | PubMed |
description | The Medicare Parts C and D Star Ratings system was established to improve care quality in Medicare. Previous studies reported racial/ethnic disparities in the calculation of medication adherence measures of Star Ratings in patients with diabetes, hypertension, and hyperlipidemia. This study aimed to identify possible racial/ethnic disparities in the calculation of adherence measures of Medicare Part D Star Ratings among patients with Alzheimer’s disease and related dementias (ADRD) and diabetes, hypertension, or hyperlipidemia. This retrospective study analyzed the 2017 Medicare data and Area Health Resources Files. Non-Hispanic White (White) patients were compared to Black, Hispanic, Asian/Pacific Islander (Asian), and other patients on their likelihood of being included in the calculation of adherence measures for diabetes, hypertension, and/or hyperlipidemia. To adjust for the individual/community characteristics, logistic regression was used when the outcome is the inclusion in the calculation of one adherence measure; multinomial regression was used when examining the inclusion in the calculation of multiple adherence measures. Analyzing the data of 1438,076 Medicare beneficiaries with ADRD, this study found that Black (adjusted odds ratio, or OR = 0.79, 95% confidence interval, or 95% CI = 0.73–0.84) and Hispanic (OR = 0.82, 95% CI = 0.75–0.89) patients were less likely than White patients to be included in the calculation of adherence measure for diabetes medications. Further, Black patients were less likely to be included in the calculation of the adherence measure for hypertension medications than White patients (OR = 0.81, 95% CI = 0.78–0.84). All minorities were less likely to be included in calculating the adherence measure for hyperlipidemia medications than Whites. The ORs for Black, Hispanic, and Asian patients were 0.57 (95% CI = 0.55–0.58), 0.69 (95% CI = 0.64–0.74), and 0.83 (95% CI = 0.76–0.91), respectively. Minority patients were generally likely to be included in the measure calculation of fewer measures than White patients. Racial/ethnic disparities were observed in the calculation of Star Ratings measures among patients with ADRD and diabetes, hypertension, and/or hyperlipidemia. Future studies should explore possible causes of and solutions to these disparities. |
format | Online Article Text |
id | pubmed-10158876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-101588762023-05-05 Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias Tsang, Chi Chun Steve Zhang, Xiangjun Barenie, Rachel Elizabeth Cernasev, Alina Miller, Nancy A. Wan, Jim Y. Tsao, Jack W. Wang, Junling Medicine (Baltimore) 4600 The Medicare Parts C and D Star Ratings system was established to improve care quality in Medicare. Previous studies reported racial/ethnic disparities in the calculation of medication adherence measures of Star Ratings in patients with diabetes, hypertension, and hyperlipidemia. This study aimed to identify possible racial/ethnic disparities in the calculation of adherence measures of Medicare Part D Star Ratings among patients with Alzheimer’s disease and related dementias (ADRD) and diabetes, hypertension, or hyperlipidemia. This retrospective study analyzed the 2017 Medicare data and Area Health Resources Files. Non-Hispanic White (White) patients were compared to Black, Hispanic, Asian/Pacific Islander (Asian), and other patients on their likelihood of being included in the calculation of adherence measures for diabetes, hypertension, and/or hyperlipidemia. To adjust for the individual/community characteristics, logistic regression was used when the outcome is the inclusion in the calculation of one adherence measure; multinomial regression was used when examining the inclusion in the calculation of multiple adherence measures. Analyzing the data of 1438,076 Medicare beneficiaries with ADRD, this study found that Black (adjusted odds ratio, or OR = 0.79, 95% confidence interval, or 95% CI = 0.73–0.84) and Hispanic (OR = 0.82, 95% CI = 0.75–0.89) patients were less likely than White patients to be included in the calculation of adherence measure for diabetes medications. Further, Black patients were less likely to be included in the calculation of the adherence measure for hypertension medications than White patients (OR = 0.81, 95% CI = 0.78–0.84). All minorities were less likely to be included in calculating the adherence measure for hyperlipidemia medications than Whites. The ORs for Black, Hispanic, and Asian patients were 0.57 (95% CI = 0.55–0.58), 0.69 (95% CI = 0.64–0.74), and 0.83 (95% CI = 0.76–0.91), respectively. Minority patients were generally likely to be included in the measure calculation of fewer measures than White patients. Racial/ethnic disparities were observed in the calculation of Star Ratings measures among patients with ADRD and diabetes, hypertension, and/or hyperlipidemia. Future studies should explore possible causes of and solutions to these disparities. Lippincott Williams & Wilkins 2023-05-05 /pmc/articles/PMC10158876/ /pubmed/37144996 http://dx.doi.org/10.1097/MD.0000000000033641 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
spellingShingle | 4600 Tsang, Chi Chun Steve Zhang, Xiangjun Barenie, Rachel Elizabeth Cernasev, Alina Miller, Nancy A. Wan, Jim Y. Tsao, Jack W. Wang, Junling Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias |
title | Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias |
title_full | Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias |
title_fullStr | Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias |
title_full_unstemmed | Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias |
title_short | Disparities associated with Medicare Part D Star Ratings measures among patients with Alzheimer’s disease and related dementias |
title_sort | disparities associated with medicare part d star ratings measures among patients with alzheimer’s disease and related dementias |
topic | 4600 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158876/ https://www.ncbi.nlm.nih.gov/pubmed/37144996 http://dx.doi.org/10.1097/MD.0000000000033641 |
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