ArticleAnnals of internal medicine2015
Did Medicare Part D Affect National Trends in Health Outcomes or Hospitalizations? A Time-Series Analysis.
Article in Annals of internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pharmaceutical policies: effects of regulating drug insurance schemes.The Cochrane database of systematic reviews · 2022Pooled it
- Prescription Drug Coverage and Outcomes of Myeloma Therapy Among Medicare Beneficiaries.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018Article
- False Dichotomies and Health Policy Research Designs: Randomized Trials Are Not Always the Answer.Journal of general internal medicine · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundMedicare Part D increased economic access to medications, but its effect on population-level health outcomes and use of other medical services remains unclear.
objectiveTo examine changes in health outcomes and medical services in the Medicare population after implementation of Part D.
designPopulation-level longitudinal time-series analysis with generalized linear models.
settingCommunity. PATIENTS: Nationally representative sample of Medicare beneficiaries (n = 56,293 [unweighted and unique]) from 2000 to 2010. MEASUREMENTS: Changes in self-reported health status, limitations in activities of daily living (ADLs) (ADLs and instrumental ADLs), emergency department visits and hospital admissions (prevalence, counts, and spending), and mortality. Medicare claims data were used for confirmatory analyses.
resultsFive years after Part D implementation, no clinically or statistically significant reductions in the prevalence of fair or poor health status or limitations in ADLs or instrumental ADLs, relative to historical trends, were detected. Compared with trends before Part D, no changes in emergency department visits, hospital admissions or days, inpatient costs, or mortality after Part D were seen. Confirmatory analyses were consistent. LIMITATIONS: Only total population-level outcomes were studied. Self-reported measures may lack sensitivity.
conclusionFive years after implementation, and contrary to previous reports, no evidence was found of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
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Registered trials
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