The effect of depression and cognitive impairment on enrollment in Medicare Part D.

TitleThe effect of depression and cognitive impairment on enrollment in Medicare Part D.
Publication TypeJournal Article
Year of Publication2009
AuthorsZivin, K, Kabeto, MU, Kales, HC, Langa, KM
JournalJ Am Geriatr Soc
Volume57
Issue8
Pagination1433-40
Date Published2009 Aug
ISSN Number1532-5415
Call Numbernewpubs20090908_Zivin_etal.pdf
KeywordsAged, Aged, 80 and over, Chi-Square Distribution, Cognition Disorders, depression, Female, Humans, Logistic Models, Longitudinal Studies, Male, Medicare Part D, Middle Aged, Patient Participation, Risk Factors, United States
Abstract

OBJECTIVES: To examine concerns that vulnerable populations, such as depressed or cognitively impaired beneficiaries would have challenges accessing Part D coverage.

DESIGN: Logistic regression analysis was used to assess whether elderly Medicare beneficiaries with depression or cognitive impairment differentially planned to and actually signed up for Part D.

SETTING: 2004 and 2006 data from the Health and Retirement Study (HRS) were used, including a subsample that completed the Prescription Drug Study (PDS) in 2005.

PARTICIPANTS: Nine thousand five hundred ninety-three HRS respondents and 3,567 PDS respondents.

MEASUREMENTS: The outcome variables of interest were planned and actual enrollment in Part D. The independent variables were depression and cognitive impairment status. The analyses were adjusted using clinical and demographic predictors including age, sex, race or ethnicity, educational attainment, net worth, marital status, health status, number of health conditions being treated with prescription medications, and presence of a caregiver.

RESULTS: Although having depression or cognitive impairment was associated with a higher likelihood of planning to and actually signing up for Part D in unadjusted analyses, in adjusted analyses, having depression or cognitive impairment was not significantly associated with whether Medicare beneficiaries planned to enroll in or actually enrolled in Part D.

CONCLUSION: Vulnerable Medicare beneficiaries with depression or cognitive impairment were able to access Part D benefits to the same extent as nonvulnerable beneficiaries. More research is needed to determine how well Part D meets the needs of these populations.

DOI10.1111/j.1532-5415.2009.02348.x
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/19515100?dopt=Abstract

Endnote Keywords

Depression/Cognition/Medicare

Endnote ID

20860

Alternate JournalJ Am Geriatr Soc
Citation Key7311
PubMed ID19515100
PubMed Central IDPMC2810264
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
R01 AG027010-03 / AG / NIA NIH HHS / United States
R01 AG 027010 / AG / NIA NIH HHS / United States
P30 AG012846 / AG / NIA NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
R01 AG027010 / AG / NIA NIH HHS / United States