Cost-related delay in filling prescriptions and health care ratings among medicare advantage recipients

Toral J. Parikh, Christian D. Helfrich, Ana Quinones, Gillian L. Marshall-Fabien, Lena K. Makaroun, Marissa A. Black, Stephen M. Thielke

Research output: Contribution to journalArticle

Abstract

Despite higher health care needs, older adults often have limited and fixed income. Approximately a quarter of them report not filling or delaying prescription medications due to cost (cost-related prescription delay, CRPD). To ascertain the association between CRPD and satisfaction with health care, secondary analysis of the 2012 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare Advantage Survey was performed.Regression models quantified the association between CRPD and rating of personal doctor, specialist, and overall health care. Models were adjusted for demographic, health-related, and socioeconomic characteristics. 274,996 Medicare Advantage enrollees were mailed the CAHPS survey, of which 101,910 (36.8%) returned a survey that had responses to all the items we analyzed. CRPD was assessed by self-report of delay in filling prescriptions due to cost. Health care ratings were on a 0-10 scale. A score ≤ 5 was considered a poor rating of care.In unadjusted models, CRPD more than doubled the relative risk (RR) for poor ratings of personal doctor (RR 2.34), specialist (RR 2.14), and overall health care (RR 2.40). Adjusting for demographics and health status slightly reduced the RRs to 1.9, but adjusting for low-income subsidy and lack of insurance for medications did not make a difference.CRPD is independently associated with poor ratings of medical care, regardless of health, financial or insurance status. Providers might reduce patients' financial stress and improve patient satisfaction by explicitly discussing prescription cost and incorporating patient priorities when recommending treatments.

Original languageEnglish (US)
Pages (from-to)e16469
JournalMedicine
Volume98
Issue number31
DOIs
StatePublished - Aug 1 2019

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Medicare Part C
Prescriptions
Delivery of Health Care
Costs and Cost Analysis
Health Personnel
Health Status
Demography
Insurance Coverage
Insurance
Patient Satisfaction
Self Report

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Parikh, T. J., Helfrich, C. D., Quinones, A., Marshall-Fabien, G. L., Makaroun, L. K., Black, M. A., & Thielke, S. M. (2019). Cost-related delay in filling prescriptions and health care ratings among medicare advantage recipients. Medicine, 98(31), e16469. https://doi.org/10.1097/MD.0000000000016469

Cost-related delay in filling prescriptions and health care ratings among medicare advantage recipients. / Parikh, Toral J.; Helfrich, Christian D.; Quinones, Ana; Marshall-Fabien, Gillian L.; Makaroun, Lena K.; Black, Marissa A.; Thielke, Stephen M.

In: Medicine, Vol. 98, No. 31, 01.08.2019, p. e16469.

Research output: Contribution to journalArticle

Parikh, TJ, Helfrich, CD, Quinones, A, Marshall-Fabien, GL, Makaroun, LK, Black, MA & Thielke, SM 2019, 'Cost-related delay in filling prescriptions and health care ratings among medicare advantage recipients', Medicine, vol. 98, no. 31, pp. e16469. https://doi.org/10.1097/MD.0000000000016469
Parikh, Toral J. ; Helfrich, Christian D. ; Quinones, Ana ; Marshall-Fabien, Gillian L. ; Makaroun, Lena K. ; Black, Marissa A. ; Thielke, Stephen M. / Cost-related delay in filling prescriptions and health care ratings among medicare advantage recipients. In: Medicine. 2019 ; Vol. 98, No. 31. pp. e16469.
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