title: The effect of Medicare Part D on health care utilization for non-elderly Medicare recipients with disabilities.
abstract: BACKGROUND
  The effect of Medicare Part D prescription drug coverage on non-elderly beneficiaries, most of whom have disabilities, has not been fully explored.
  
  
  OBJECTIVE
  The objective of this study was to estimate the impact of Medicare Part D on expenditures and utilization of prescription drugs, hospitalizations, physician office visits and emergency department visits in non-elderly Medicare beneficiaries with disabilities.
  
  
  METHODS
  Using Medical Expenditure Panel Survey (MEPS) data from 2005 to 2006, we assembled a cohort of non-elderly Medicare beneficiaries and controls using propensity score matching. We used zero-inflated negative binomial regressions and generalized linear models to examine the effect of Medicare Part D on health care utilization and expenditures, respectively. We controlled for demographic characteristics, census region of residence, and self-reported health status.
  
  
  RESULTS
  We were able to match 299 Medicare non-recipients to 299 Medicare recipients. The mean (SD) age was 49.8 (10.7) years for the Medicare non-recipients and 49.9 (10.0) years for Medicare recipients. While the introduction of Medicare Part D was not associated with a significant change in the number of prescriptions consumed by this group of individuals, there was a significant decrease in out-of-pocket prescription drug expenses as well as expenses paid for by Medicaid and private insurance.
  
  
  CONCLUSIONS
  Our study is the first to examine the impact of Medicare Part D on non-elderly Medicare beneficiaries. We find that the introduction of Medicare Part D did not lead to changes in prescription drug consumption, only in the method of payment.
authors.affiliation: Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; VA Salt Lake City Health Care System, Salt Lake City, UT, USA. Electronic address: Richard.Nelson@utah.edu.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Nelson
authors.affiliation: Department of Political Science, University of Utah, Salt Lake City, UT, USA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Nelson
authors.affiliation: VA Salt Lake City Health Care System, Salt Lake City, UT, USA; Infection Control Program, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Huttner
authors.affiliation: Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
authors.forename: Adi
authors.initials: A
authors.lastname: Gundlapalli
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D006233:Persons with Disabilities; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008297:Male; D008484:Medicaid; D054524:Medicare Part D; D008875:Middle Aged; D055553:Prescription Drugs / Q000191:economics*; D012044:Regression Analysis; D014481:United States
chemical_list: D055553:Prescription Drugs
keywords: Costs; Health insurance; Medicare Part D; Prescription drugs