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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...

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Autores principales: Tsang, Chi Chun Steve, Zhang, Xiangjun, Barenie, Rachel Elizabeth, Cernasev, Alina, Miller, Nancy A., Wan, Jim Y., Tsao, Jack W., Wang, Junling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
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.
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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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