Race/Ethnicity and Economic Differences in Cost-Related Medication Underuse Among Insured Adults With Diabetes The Translating Research Into Action for Diabetes Study

被引：80

作者：

Tseng, Chien-Wen ^{[1
,2
]}

Tierney, Edward F. ^{[3
]}

Gerzoff, Robert B. ^{[3
]}

Dudley, R. Adams ^{[4
,5
]}

Waitzfelder, Beth ^{[1
]}

Ackermann, Ronald T. ^{[6
]}

Karter, Andrew J. ^{[7
]}

Piette, John ^{[8
,9
]}

Crosson, Jesse C. ^{[10
,11
]}

Ngo-Metzger, Quyen ^{[12
,13
]}

Chung, Richard ^{[14
]}

Mangione, Carol M. ^{[15
,16
]}

机构：

[1] Pacific Hlth Res Inst, Honolulu, HI 96813 USA

[2] Univ Hawaii, John A Burns Sch Med, Dept Family Med & Community Hlth, Honolulu, HI 96822 USA

[3] Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA

[4] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[5] Univ Calif San Francisco, Inst Hlth Policy Studies, San Francisco, CA 94143 USA

[6] Indiana Univ, Sch Med, Dept Med, Indianapolis, IN USA

[7] Kaiser Permanente Med Care Program, Div Res, Oakland, CA 94611 USA

[8] Univ Michigan, Dept Vet Affairs Ctr Practice Management & Outcom, Ann Arbor, MI 48109 USA

[9] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA

[10] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Family Med, Newark, NJ 07103 USA

[11] Robert Wood Johnson Med Sch, Dept Family Med, Div Res, Somerset, NJ USA

[12] Univ Calif Irvine, Coll Med, Div Gen Med & Primary Care, Irvine, CA 92717 USA

[13] Univ Calif Irvine, Coll Med, Ctr Hlth Policy Res, Irvine, CA 92717 USA

[14] Hawaii Med Serv Assoc, Honolulu, HI USA

[15] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[16] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA

来源：

DIABETES CARE | 2008年 / 31卷 / 02期

关键词：

D O I：

10.2337/dc07-1341

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE - To examine racial/ethnic and economic variation in cost-related medication underuse among insured adults with diabetes. RESEARCH DESIGN AND METHODS - We surveyed 5,086 participants from the multicenter Translating Research Into Action lot Diabetes Study. Respondents reported whether used less medication because of cost in the past 12 months. We examined unadjusted and they adjusted rates of cost-related medication underuse, using hierarchical regression, to determine whether race/ethnicity differences Still existed after accounting for economic, health, and other demographic variables. RESULTS - Participants were 48% white, 14% African American, 14% Latino, 15% Asian/Pacific Islander, and 8% other. Overall, 14% reported cost-related medication underuse. Unadjusted rates were highest for Latinos (23%) and African Americans (17%) compared with Whites (13%), Asian/Pacific Islanders (11%), and others (15%). In multivariate analyses, race/ethnicity significantly predicted cost-related medication underuse (P = 0.048). However, adjusted rates were only slightly higher for Latinos (14%), than whites (10%) (P = 0.026) and were not significantly different for African Americans (11%), Asian/Pacific Islanders (7%), and others (11%). Income and out-of-pocket drug costs Showed the greatest differences in adjusted rates of cost-related medication underuse (15 vs. 5% for participants with income <= 5$25,000 vs. >$50,000 and 24 vs. 7% for participants With out-of-pocket costs >$150 per month vs. <=$50 per month. CONCLUSIONS - one in seven participants reported cost-related medication underuse. Rates were highest among African Americans and Latinos but were related to lower incomes and higher out-of-pocket drug costs in these groups. Interventions to decrease racial/ethnic disparities in cost-related medication underuse should focus on decreasing financial barriers to medications.

引用

页码：261 / 266

页数：6

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