Diffusion of Prescription Drugs for Alzheimer's Disease Among Older Adults

阿尔茨海默病处方药在老年人中的传播

• 批准号: 7136052
• 负责人: Chandrakala Ganesh
• 金额: $ 3.2万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-15 至 2008-05-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7136052
• 关键词: Alzheimer' s disease; behavioral /social science research tag; brain disorder chemotherapy; clinical research; drug administration rate /duration; health care cost /financing; health disparity; human data; longitudinal human study; patient care management; patient care personnel attitude; racial /ethnic difference; socioeconomics

DESCRIPTION (provided by the applicant): Alzheimer's disease (AD) affects over 4 million Americans, an estimate that is projected to increase to 14 million by 2050. Technological advances have led to the approval of 5 drugs to treat AD. While the demand for these drugs has been rising rapidly since their introduction, there is little nationally representative research available on individuals who use them. The proposed research has 3 main objectives. First, it will examine the trends in diffusion of AD drugs among community residing Medicare beneficiaries from 1996 to 2002. Second, the study will determine if disparities exist in the adoption and use of drugs for AD. Finally, it would identify the determinants of current and future health care costs associated with the adoption and use of these drugs. All the 3 objectives directly relate to the mission of the agency with reference to health and health care of the elderly and minority populations. The Anderson's behavioral model of health services utilization and the Roger's diffusion of innovations model provide the conceptual framework for the study. Data on community dwelling beneficiaries from the Medicare Current Beneficiary Survey, years 1996 to 2002, and data on health care systems from the Area Resource File will be used. Analysis procedures would be conducted on 3 samples: beneficiaries with only a claims diagnosis of AD, beneficiaries with a claims diagnosis or a survey report of AD, and beneficiaries with a claims diagnosis, or survey report of AD or those using any AD drug. This categorization would help in determining how the results would change based on varying sample definitions. Analyses procedures will include conducting basic descriptive analysis on the numbers and types of drugs that are used by elderly with AD. Chi-squares would be used to test for absolute differences in the utilization of AD drugs by beneficiaries with AD. The trends in diffusion would be captured by estimating hazard models on adoption of AD drug by beneficiaries from 1996 to 2001. Disparities would be identified in 2 ways. First by estimating logit models for each year of available data and second by pooling the data and estimating a multilevel model where persons nested within a given year. In addition, racial difference would be calculated using Oaxaca decomposition techniques. Finally, the Generalized Linear Model using gamma regression functions would be employed to analyze current and projected costs. Findings from this study would help in integrating aspects of access, quality and costs of health care services such as prescription drugs for elderly with Alzheimer's disease.

描述（由申请人提供）：阿尔茨海默氏病（AD）影响超过400万美国人，该估计预计到2050年将增加到1400万。技术进步导致了5种药物来治疗AD。自从引入以来，对这些药物的需求一直在迅速上升，但对于使用这些药物的人来说，几乎几乎几乎没有使用这些药物的人。拟议的研究有3个主要目标。首先，它将研究1996年至2002年居住在医疗保险受益人的社区中广告药物扩散的趋势。其次，该研究将确定在采用和使用AD的药物中是否存在差异。最后，它将确定与采用和使用这些药物有关的当前和未来医疗保健成本的决定因素。所有3个目标都与该机构的使命有关，参考老年人和少数民族的健康和卫生保健。安德森（Anderson）的卫生服务利用率行为模型和罗杰（Roger）的创新模型的扩散为研究提供了概念框架。 1996年至2002年，Medicare当前受益人调查的社区住宅受益人的数据以及来自地区资源文件的医疗保健系统的数据。分析程序将对3个样本进行：仅具有索赔诊断为AD的受益人，具有索赔诊断的受益人或AD的调查报告，以及具有索赔诊断的受益人，或AD的调查报告或使用AD药物的调查报告。这种分类将有助于根据不同的样本定义来确定结果将如何变化。分析程序将包括对老年人与AD使用的药物数量和类型进行基本描述性分析。卡方将用于测试AD受益人利用AD药物的绝对差异。从1996年至2001年，通过估计受益人采用AD药物的危害模型，将捕获扩散的趋势。将以两种方式确定差异。首先，通过估算每年可用数据的logit模型，其次通过汇总数据并估算一个在给定年内嵌套的人嵌套的多级模型。另外，种族差异将使用瓦哈卡分解技术计算。最后，将采用使用伽马回归函数的广义线性模型来分析当前和预计的成本。这项研究的结果将有助于整合卫生保健服务的获取，质量和成本的各个方面，例如老年人的处方药和阿尔茨海默氏病。