The differential rates in cost-related non-adherence to medical care by gender in the US adult population

Zhang, James; Crowe, James M.; Meltzer, David O.

doi:10.1080/13696998.2017.1326383

Cited by 19 publications

(10 citation statements)

References 18 publications

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“…The literature, however, only partially supports this link. 22 , 24 , 26 Conversely, our findings did not corroborate sociodemographic factors reported elsewhere, for example, younger age, 20 – 22 female gender, 20 , 21 , 23 , 27 lower educational level, 24 and unemployment. 21 Overall, however, this study confirmed the importance of patient-level variables derived from the Integrative Model of Behavioral Prediction.…”

Section: Methodscontrasting

confidence: 99%

“…Understanding CRMNA and identifying at-risk patients require a clearer knowledge of its determinants and/or correlates. Findings in chronically ill and transplant populations show that sociodemographic risk factors include younger age, 20 – 22 female gender, 20 , 22 , 23 not being married, 24 a lower education level, 24 unemployment, 21 and being black or Hispanic. 22 , 24 – 26 Patient-level factors linked with CRMNA include patient-perceived medication regimen-related financial burden, 27 perceived financial stress, 28 financial insecurity regarding healthcare, 28 food insecurity, 25 , 28 health beliefs, 22 , 29 and private health insurance coverage.…”

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confidence: 99%

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Prevalence and Correlates of Cost-Related Medication Nonadherence to Immunosuppressive Drugs After Heart Transplantation

et al. 2020

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Background Cost-related medication nonadherence (CRMNA) refers to not taking medications as prescribed because of difficulties paying for them. Objectives The aims of this study were (1) to assess the prevalence of CRMNA to immunosuppressants in heart transplant recipients internationally and (2) to determine multilevel correlates (patient, center, and healthcare system levels) of CRMNA. Methods Using data from the cross-sectional international BRIGHT study, applying multistaged sampling, CRMNA was assessed via 3 self-report items in 1365 patients from 36 heart transplant centers in 11 countries. Cost-related medication nonadherence was defined as any positive answer on any of the 3 items. Healthcare system–level (ie, insurance coverage, out-of-pocket expenditures) and patient-level (ie, intention, perceived financial burden, cost as a barrier, a health belief regarding medication benefits, cost-related self-efficacy, and demographic factors) CRMNA correlates were assessed. Correlates were examined using mixed logistic regression analysis. Results Across all study countries, CRMNA had an average prevalence of 2.6% (range, 0% [Switzerland/Brazil] to 9.8% [Australia]) and was positively related to being single (odds ratio, 2.29; 95% confidence interval, 1.17–4.47), perceived financial burden (odds ratio, 2.15; 95% confidence interval, 1.55–2.99), and cost as a barrier (odds ratio, 2.60; 95% confidence interval, 1.66–4.07). Four protective factors were identified: white ethnicity (odds ratio, 0.37; 95% confidence interval, 0.19–0.74), intention to adhere (odds ratio, 0.44; 95% confidence interval, 0.31–0.63), self-efficacy (odds ratio, 0.54; 95% confidence interval, 0.43–0.67), and belief about medication benefit (odds ratio, 0.70; 95% confidence interval, 0.57–0.87). Regarding variability, 81.3% was explained at the patient level; 13.8%, at the center level; and 4.8%, at the country level. Conclusion In heart transplant recipients, the CRMNA prevalence varies across countries but is lower than in other chronically ill populations. Identified patient-level correlates are novel (ie, intention to adhere, cost-related barriers, and cost-related self-efficacy) and indicate patient-perceived medication cost burden.

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Section: Methodscontrasting

confidence: 99%

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confidence: 99%

Prevalence and Correlates of Cost-Related Medication Nonadherence to Immunosuppressive Drugs After Heart Transplantation

et al. 2020

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“…Of note, although the surveys asked for reports of sex, because such reports encompass a cultural indicator of a person's personal social and cultural identity rather than the biological characteristics of males and females, we use gender instead of sex in the context of CRN behaviors; such behaviors are beyond the biological difference owing to differential cultural roles by men and women. There has been robust discussion in the literature [31][32][33][34] regarding sex differences in the use of health care resources across the life span and the role of gender in contributing to such differences when socioeconomic contexts are incorporated in medical care. Although the literature on gender difference in CRN has increased, 34 to our knowledge, no study has specifically focused on the association of gender with persistence of CRN.…”

Section: Jama Network Open | Health Policymentioning

confidence: 99%

Prevalence and Persistence of Cost-Related Medication Nonadherence Among Medicare Beneficiaries at High Risk of Hospitalization

2021

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IMPORTANCE The unaffordability of drugs has been a persistent and elusive challenge in the US health care system. Little is known about the prevalence and persistence of cost-related medication nonadherence (CRN) in a population with high-cost, high-need resource utilization. OBJECTIVE To evaluate the prevalence and persistence of CRN among Medicare beneficiaries at high risk of hospitalization as well as the characteristics associated with CRN in this population. DESIGN, SETTING, AND PARTICIPANTS This cohort study used survey data from Medicare patients at high risk of hospitalization and with a life expectancy greater than 12 months at an urban academic medical center from November 6, 2012, to January 30, 2018. Patients were followed up for 12 months at 3-month intervals from baseline, for a total of 5 surveys. Data were analyzed from

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“…Medical costs are influenced by several factors including gender (Owens, 2008;Zhang, Crowe, & Meltzer, 2017). Sex differences between women and men include differences in sex hormones and their effects on system organs (Gambineri & Pelusi, 2019).…”

Section: Gendermentioning

confidence: 99%

Diagnostic costs: a research in a family medicine outpatient clinic

Şahin¹,

Esen²,

Öztürk³

2022

Acta Sci. Health Sci.

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The aim of this study is to evaluate the direct diagnostic costs for disease groups and other variables (such as gender, age, seasons) that are related to the direct diagnostic costs based on a 3-year data. The population of the study consisted of 31,401 patients who applied to family medicine outpatient clinic in Turkey between January 1st, 2016 and December 31st, 2018. With this study, we determined in which disease groups of the family medicine outpatient clinic were most frequently admitted. Then, total and average diagnostic costs for these disease groups were calculated. Three-year data gave us the opportunity to examine the trend in diagnostic costs. Based on this, we demonstrated which diseases' total and average diagnostic costs increased or decreased during 3 years. Moreover, we examined how diagnostic costs showed a trend in both Turkish liras and USA dollars’ rate for 3 years. Finally, we analysed whether the diagnostic costs differed according to variables such as age, gender and season. There has been relatively little analysis on the diagnostic costs in the previous literature. Therefore, we expect to contribute to both theorists and healthcare managers for diagnostic costs with this study.

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The differential rates in cost-related non-adherence to medical care by gender in the US adult population

Abstract: More research is needed to understand the behavioral aspects of gender difference in CRN. Patient-centered healthcare needs to take gender difference into account when addressing cost-related non-adherence behavior.

Cited by 19 publications

References 18 publications

Prevalence and Correlates of Cost-Related Medication Nonadherence to Immunosuppressive Drugs After Heart Transplantation

Prevalence and Correlates of Cost-Related Medication Nonadherence to Immunosuppressive Drugs After Heart Transplantation

Prevalence and Persistence of Cost-Related Medication Nonadherence Among Medicare Beneficiaries at High Risk of Hospitalization

Diagnostic costs: a research in a family medicine outpatient clinic

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