Regional Variation in Medication Adherence
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Abstract
An extensive literature has demonstrated geographic variation in medical services and this variation has been largely attributed to the health care system and not to regional differences in patient behavior. We use empirical Bayes shrinkage models, conditional on patient, firm, and market covariates, to investigate geographic variation in adherence to prescription medications across hospital referral regions (HRRs). Models are estimated for commercially insured patients in 11 combinations of chronic diseases and drug classes. We use factor analysis to create a market-level composite measure of adherence that we relate to adjusted market-level spending on non-drug services. We find that there is a very small amount of variation in adherence to prescription drugs across HRRs supporting the widely held assumption that geographic variation is attributable to the health system. Markets with high adherence have systematically lower medical spending, and this inverse correlation is more likely due to unobserved market traits.
©2011 Walter de Gruyter GmbH & Co. KG, Berlin/Boston
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Artikel in diesem Heft
- Article
- The Effects of Consumer-Directed Health Plans on Episodes of Health Care
- A Primer on the Economics of Prescription Pharmaceutical Pricing in Health Insurance Markets
- The Impact of Household Investments on Early Child Neurodevelopment and on Racial and Socioeconomic Developmental Gaps: Evidence from South America
- Should We Put a Thin Subsidy on the Policy Table in the Fight against Obesity?
- Does Patient Use of Medical Information Affect Physician Practice Incentives to Provide Care?
- How Do Consumer-Directed Health Plans Affect Vulnerable Populations?
- How Do Employers React to a Pay-or-Play Mandate? Early Evidence from San Francisco
- Determinants of Tobacco Control Funding: Evidence from U.S. States
- Toxic Choices: The Theory and Impact of Smoking Bans
- Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending
- Regional Variation in Medication Adherence
- Erratum
- How Do Employers React to a Pay-or-Play Mandate? Early Evidence from San Francisco
