| Autor: |
Gupta R; Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD.; Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore MD.; Hopkins Business of Health Initiative, Johns Hopkins University Baltimore MD., Yang L; Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia PA.; Center for Cardiovascular Outcomes, Quality and Evaluative Research Center University of Pennsylvania Philadelphia PA., Lewey J; Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia PA.; Center for Cardiovascular Outcomes, Quality and Evaluative Research Center University of Pennsylvania Philadelphia PA.; Division of Cardiovascular Medicine, Perelman School of Medicine University of Pennsylvania Philadelphia PA., Navathe AS; Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia PA.; Division of General Internal Medicine, Perelman School of Medicine University of Pennsylvania PA Philadelphia.; Corporal Michael J. Crescenz Veterans Affairs Medical Center PA Philadelphia.; Department of Medical Ethics and Health Policy, Perelman School of Medicine University of Pennsylvania Philadelphia PA., Groeneveld PW; Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia PA.; Center for Cardiovascular Outcomes, Quality and Evaluative Research Center University of Pennsylvania Philadelphia PA.; Division of General Internal Medicine, Perelman School of Medicine University of Pennsylvania PA Philadelphia.; Corporal Michael J. Crescenz Veterans Affairs Medical Center PA Philadelphia., Khatana SAM; Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia PA.; Center for Cardiovascular Outcomes, Quality and Evaluative Research Center University of Pennsylvania Philadelphia PA.; Division of Cardiovascular Medicine, Perelman School of Medicine University of Pennsylvania Philadelphia PA.; Corporal Michael J. Crescenz Veterans Affairs Medical Center PA Philadelphia. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of the American Heart Association [J Am Heart Assoc] 2023 Oct 03; Vol. 12 (19), pp. e030730. Date of Electronic Publication: 2023 Sep 26. |
| DOI: |
10.1161/JAHA.123.030730 |
| Abstrakt: |
Background By increasing cost sharing, high-deductible health plans (HDHPs) aim to reduce low-value health care use. The association of HDHPs with health care use and costs in patients with chronic cardiovascular disease is unknown. Methods and Results This longitudinal cohort study analyzed 57 690 privately insured patients, aged 18 to 64 years, from a large commercial claims database with chronic cardiovascular disease from 2011 to 2019. Health care entities in which all or most beneficiaries switched from being in a traditional plan to an HDHP were identified. A difference-in-differences design was used to account for differences between individuals who remained in traditional plans and those who switched to HDHPs and to assess changes in health care use and costs. Among the 934 individuals in the HDHP group and the 56 756 in the traditional plan group, switching to an HDHP was not associated with statistically significant changes in annual outpatient visits, hospitalizations, or emergency department visits (-8.3% [95% CI, -16.8 to 1.1], -28.5% [95% CI, -62.1 to 34.6], and 11.2% [95% CI, -20.9 to 56.5], respectively). Switching to an HDHP was associated with an increase of $921 (95% CI, $743-$1099) in out-of-pocket costs but no statistically significant difference in total health care costs. Conclusions Among commercially insured patients with chronic cardiovascular disease, switching to an HDHP was not associated with a change in health care use but was associated with an increase in out-of-pocket costs. Although health care use by individuals with chronic cardiovascular disease may not be sensitive to higher cost sharing associated with HDHP enrollment, there may be a significant increase in patients' financial burden. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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