FINANCIAL HARDSHIP, MEDICATION MANAGEMENT BEHAVIORS, AND PERCEIVED QUALITY OF CARE AMONG MEDICARE BENEFICIARIES
Author(s)
Kunj Patel, MSc, PhD1, Pei-Lin Huang, MHS2, Eberechukwu Onukwugha, MSc, PhD2.
1University of Maryland, Baltimore School of Pharmacy, Baltimore, MD, USA, 2Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
1University of Maryland, Baltimore School of Pharmacy, Baltimore, MD, USA, 2Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
OBJECTIVES: Personal financial hardships can have negative downstream impacts. However there is limited information to identify the domains that matter most for patient satisfaction and health status. This study aimed to identify domains of cost-related management strategies (CrMS) and quantify their association with satisfaction and health status.
METHODS: The study utilized the 2022 Medicare Current Beneficiary Survey Public Use File. Respondents were included if they participated in all three rounds and were enrolled in a Medicare prescription drug plan in 2022. Guided by published frameworks that describe cost-related coping strategies, we selected 26 variables across six domains. We used exploratory factor analysis to identify latent constructs underlying CrMS. The study outcomes included respondents’ satisfaction with: 1) healthcare quality, 2) out-of-pocket medical costs, and; 3) prescription drug costs over the past year. The fourth study outcome was self-reported health compared with the previous year. Logistic regression with fixed effects provided covariate adjusted odds ratios (AOR) and 95% confidence intervals (CI).
RESULTS: Among 5,297 respondents, 76% were White, 10% were Black and 8% were Hispanic. Twenty-two percent of respondents were full or partial dual. We identified six latent constructs. The statistically significant constructs of CrMS differed across the models. “Cost-Related Medication Non-Adherence” was significant in all models except the satisfaction with healthcare quality model. “Structural and Psychosocial Financial Hardship” was significant in all models except the satisfaction with prescription drug cost model. “Cost Driven Medication Under-Dosing” was only negatively associated with satisfaction with prescription drug costs (AOR: 0.20 [0.07 ~ 0.55]), and “Healthcare Access Burden” was only positively associated with satisfaction with healthcare quality (AOR: 6.94 [3.25 ~ 14.83]).
CONCLUSIONS: Distinct domains of CrMS were identified using exploratory factor analysis and varied in their associations with outcomes. The domains of CrMS relate to the patient experience and warrant further study among other adult populations.
METHODS: The study utilized the 2022 Medicare Current Beneficiary Survey Public Use File. Respondents were included if they participated in all three rounds and were enrolled in a Medicare prescription drug plan in 2022. Guided by published frameworks that describe cost-related coping strategies, we selected 26 variables across six domains. We used exploratory factor analysis to identify latent constructs underlying CrMS. The study outcomes included respondents’ satisfaction with: 1) healthcare quality, 2) out-of-pocket medical costs, and; 3) prescription drug costs over the past year. The fourth study outcome was self-reported health compared with the previous year. Logistic regression with fixed effects provided covariate adjusted odds ratios (AOR) and 95% confidence intervals (CI).
RESULTS: Among 5,297 respondents, 76% were White, 10% were Black and 8% were Hispanic. Twenty-two percent of respondents were full or partial dual. We identified six latent constructs. The statistically significant constructs of CrMS differed across the models. “Cost-Related Medication Non-Adherence” was significant in all models except the satisfaction with healthcare quality model. “Structural and Psychosocial Financial Hardship” was significant in all models except the satisfaction with prescription drug cost model. “Cost Driven Medication Under-Dosing” was only negatively associated with satisfaction with prescription drug costs (AOR: 0.20 [0.07 ~ 0.55]), and “Healthcare Access Burden” was only positively associated with satisfaction with healthcare quality (AOR: 6.94 [3.25 ~ 14.83]).
CONCLUSIONS: Distinct domains of CrMS were identified using exploratory factor analysis and varied in their associations with outcomes. The domains of CrMS relate to the patient experience and warrant further study among other adult populations.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR118
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient Behavior and Incentives
Disease
No Additional Disease & Conditions/Specialized Treatment Areas