Racial and ethnic disparities in meeting MTM eligibility criteria among patients with asthma.
BACKGROUND
Asthma is one of the most frequently targeted chronic diseases in the medication therapy management (MTM) programs of the Medicare prescription drug (Part D) benefits. Although racial and ethnic disparities in meeting eligibility criteria for MTM services have been reported, little is known about whether there would be similar disparities among adults with asthma in the United States.


METHODS
Adult patients with asthma (age ≥ 18) from Medical Expenditure Panel Survey (2011-2012) were analyzed. Bivariate analyses were conducted to compare the proportions of patients who would meet Medicare MTM eligibility criteria between non-Hispanic Blacks (Blacks), Hispanics and non-Hispanic Whites (Whites). Survey-weighted logistic regression was performed to adjust for patient characteristics. Main and sensitivity analyses were conducted to cover the entire range of the eligibility thresholds used by Part D plans in 2011-2012.


RESULTS
The sample included 4,455 patients with asthma, including 2,294 Whites, 1,218 Blacks, and 943 Hispanics. Blacks and Hispanics had lower proportions of meeting MTM eligibility criteria than did Whites (P < 0.001). According to the main analysis, Blacks and Hispanics had 36% and 32% lower, respectively, likelihood of MTM eligibility than Whites (odds ratio [OR]: 0.64, 95% confidence interval [CI]: 0.45-0.90; OR: 0.68, 95% CI: 0.47-0.98, respectively). Similar results were obtained in sensitivity analyses.


CONCLUSIONS
There are racial and ethnic disparities in meeting Medicare Part D MTM eligibility criteria among adult patients with asthma. Future studies should examine the implications of such disparities on health outcomes of patients with asthma and explore alternative MTM eligibility criteria.
a Department of Respiratory Medicine , Shandong Provincial Qianfoshan Hospital, Shandong University , Shandong , China.
Degan
D
Lu
b University of Tennessee College of Pharmacy , Memphis , TN , USA.
Yanru
Y
Qiao
c Department of Preventive Medicine , University of Tennessee Health Science Center College of Medicine , Memphis , TN , USA.
Karen C
KC
Johnson
b University of Tennessee College of Pharmacy , Memphis , TN , USA.
Junling
J
Wang
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001249:Asthma / Q000188:drug therapy*; D004608:Eligibility Determination; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D054524:Medicare Part D; D054539:Medication Therapy Management / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D044469:Racial Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
Asthma; disparity; eligibility criteria; ethnicity; medication therapy management services; race
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