title: Medicare Part D Implementation and Associated Health Impact Among Older Adults in the United States.
abstract: This study examined the effect of Medicare (Part D) implementation on health outcomes among U.S. older adults. Study participants were initially extracted from the 2004-2008 Health and Retirement Study (HRS). Data from respondents who further participated in the HRS 2005-2007 Prescription Drug Study were analyzed (N = 746). This was a retrospective pre-post design with a treatment and a control group. The difference-in-differences approach with panel ordered logistic regressions was used to examine the Part D effect on three patient health outcomes before and after the implementation, controlling for patient sociodemographic characteristics. People with continuous Part D enrollment from 2006-2008 were less likely to have a worse self-rated health than those who were not enrolled in Part D (odds ratio [OR] = 0.48; p < .05). A higher Charlson Comorbidity Index score was associated with a higher likelihood of having worse self-rated overall health, worse mental health, and worse activities of daily living impairment (ORs = 1.12, 1.17, and 1.36, respectively; all ps < .001). The Part D implementation appears to have a positive effect on older adults' overall health outcomes. A decrease in out-of-pocket cost for health care may encourage older adults to utilize more needed medications, which in turn helped maintain better health.
authors: 1 Department of Public Health, University of Illinois, Springfield, Illinois, USA.
authors: Cheng-Chia
authors: CC
authors: Chen
authors: 2 Department of Applied Health Science, Indiana University School of Public Health, Bloomington, Indiana, USA.
authors: Hsien-Chang
authors: HC
authors: Lin
authors: 2 Department of Applied Health Science, Indiana University School of Public Health, Bloomington, Indiana, USA.
authors: Dong-Chul
authors: DC
authors: Seo
mesh_terms: D000368:Aged; D006299:Health Services for the Aged; D006801:Humans; D054524:Medicare Part D / Q000191:economics*; D014481:United States
keywords: Medicare Part D; health outcomes; prescription drugs; self-rated health