The Medicare+Choice (M+C) program has faced successive waves of plan withdrawals since 1999. We collected data from 1,055 beneficiaries who were involuntarily disenrolled from a health maintenance organization (HMO) that withdrew from six large markets in 1999 to investigate how they were impacted by the forced change in coverage. Administrative data from this HMO were used to oversample benefi...

BACKGROUND Medicare Part D, introduced in January 2006, was intended to decrease beneficiaries' out-of-pocket expenditures on medications. METHODS We examined whether this policy was successful in achieving this goal, including effects on Medicare beneficiaries without previous drug coverage and those who previously received coverage through Medicaid, in a longitudinal study of out-of-pocket ...

Por otro lado, la capacitación es otro aspecto que debe de considerarse, en ese sentido, el Reglamento de tengan en ética en investigación y uno de sus miembros debe tener capacitación en bioética El costo de la capacitación es un tema que no ha sido cuenta que el trabajo que realizan los miembros de los exige no solo es de tres a cuatro horas de sesión que se hace como parte de la carga labora...

OBJECTIVE To assess the state of national health research systems of countries in the World Health Organization (WHO) African Region. DESIGN A questionnaire-based survey METHODS: Structured questionnaires were used to solicit health research systems' relevant information from key informants in each country. SETTING Forty-six Member States of the WHO African Region. PARTICIPANTS Key inform...

OBJECTIVE To determine the effect of joining HMOs (health maintenance organizations) on the inpatient utilization of Medicare beneficiaries. DATA SOURCES We linked enrollment data on Medicare beneficiaries to patient discharge data from the California Office of Statewide Health Planning and Development (OSHPD) for 1991-1995. DESIGN AND SAMPLE A quasi-experimental design comparing inpatient ...

BACKGROUND The association between the Medicare Part D low-income subsidy (LIS), gap coverage, and outcomes such as medical expenditures, prescription fills, and medication adherence is not well understood. The purpose of this study was to examine the relationship between the LIS and these measures for patients within a large, national Part D plan in the United States. METHODS In this cross-s...

Participation provide a unique opportunity to identify major types of Social Security beneficiaries and to characterize their relative socioeconomic status. Five types of beneficiaries are identified: the two types of worker beneficiaries (retired workers and disabled workers), and the three major groups with benefits based on someone else’s work record (aged wives, aged widows, and minor child...

BACKGROUND Findings from previous studies on an association between obesity and colorectal cancer (CRC) screening are inconsistent and very few studies have utilized national level databases in the United States (US). METHODS A cross-sectional study was conducted using data from the 2005 Medicare Current Beneficiary Survey to describe CRC screening rate by obesity status. RESULTS Of a 15,76...

OBJECTIVE To evaluate the impact of Medicare Part D coverage gap (donut hole) on adherence to diabetes medications. STUDY DESIGN Retrospective cohort analysis based on pharmacy claims data. METHODS The sample included 12,881 Medicare Part D beneficiaries with diabetes who entered the coverage gap in 2008. Sample patients had 3 different levels of coverage in the donut hole: no coverage, gen...

Medicare Current Beneficiary Survey (MCBS) Access to Care data indicate a five-percentage-point decline in the share of Medicare beneficiaries having Medigap coverage between 1996 and 1999; this was matched by a commensurate rise in the share enrolled in Medicare HMOs, contributing to an increase in the percentage with drug coverage. During this period, high-income beneficiaries, and to a lesse...