IDEAS home Printed from https://ideas.repec.org/a/bpj/fhecpo/v14y2011i2n8.html
   My bibliography  Save this article

Regional Variation in Medication Adherence

Author

Listed:
  • Gibson Teresa B

    (Thomson Reuters, teresa.gibson@thomsonreuters.com)

  • Landrum Mary Beth

    (Harvard Medical School, landrum@hcp.med.harvard.edu)

  • Batata Amber

    (Pfizer Inc., amber.batata@pfizer.com)

  • Fendrick A. Mark

    (University of Michigan, Amfen@umich.edu)

  • Wang Sara

    (Formerly of Thomson Reuters, csshw@yahoo.com)

  • Chernew Michael E.

    (Harvard Medical School, chernew@hcp.med.harvard.edu)

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.

Suggested Citation

  • Gibson Teresa B & Landrum Mary Beth & Batata Amber & Fendrick A. Mark & Wang Sara & Chernew Michael E., 2011. "Regional Variation in Medication Adherence," Forum for Health Economics & Policy, De Gruyter, vol. 14(1), pages 1-22, July.
    • Handle: RePEc:bpj:fhecpo:v:14:y:2011:i:2:n:8
    DOI: 10.2202/1558-9544.1249
    as

    Download full text from publisher

    File URL: https://doi.org/10.2202/1558-9544.1249
    Download Restriction: For access to full text, subscription to the journal or payment for the individual article is required.
    File URL: https://libkey.io/10.2202/1558-9544.1249?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Amitabh Chandra & Douglas O. Staiger, 2007. "Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks," Journal of Political Economy, University of Chicago Press, vol. 115(1), pages 103-140.
    2. Francis Vella, 1998. "Estimating Models with Sample Selection Bias: A Survey," Journal of Human Resources, University of Wisconsin Press, vol. 33(1), pages 127-169.
    3. Duan, Naihua, et al, 1984. "Choosing between the Sample-Selection Model and the Multi-part Model," Journal of Business & Economic Statistics, American Statistical Association, vol. 2(3), pages 283-289, July.
    4. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    5. Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-126, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2012. "The Influence of BMI, Obesity and Overweight on Medical Costs: A Panel Data Approach," Working Papers 2012-08, FEDEA.
    2. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2015. "The influence of obesity and overweight on medical costs: a panel data perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 161-173, March.
    3. Galina Besstremyannaya, 2012. "Estimating income equity in social health insurance system," Working Papers w0172, New Economic School (NES).
    4. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2012. "The Influence of BMI, Obesity and Overweight on Medical Costs: A Panel Data Approach," Working Papers 2012-08, FEDEA.
    5. Borislava Mihaylova & Andrew Briggs & Anthony O'Hagan & Simon G. Thompson, 2011. "Review of statistical methods for analysing healthcare resources and costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 897-916, August.
    6. Silva João M. C. Santos & Tenreyro Silvana & Windmeijer Frank, 2015. "Testing Competing Models for Non-negative Data with Many Zeros," Journal of Econometric Methods, De Gruyter, vol. 4(1), pages 29-46, January.
    7. Chen, Chin-Shyan & Liu, Tsai-Ching & Chen, Li-Mei, 2003. "National Health Insurance and the antenatal care use: a case in Taiwan," Health Policy, Elsevier, vol. 64(1), pages 99-112, April.
    8. Liu, Lei & Strawderman, Robert L. & Cowen, Mark E. & Shih, Ya-Chen T., 2010. "A flexible two-part random effects model for correlated medical costs," Journal of Health Economics, Elsevier, vol. 29(1), pages 110-123, January.
    9. Vecino-Ortiz, Andrés Ignacio, 2008. "Determinants of demand for antenatal care in Colombia," Health Policy, Elsevier, vol. 86(2-3), pages 363-372, May.
    10. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    11. Kevin E. Staub, 2014. "A Causal Interpretation of Extensive and Intensive Margin Effects in Generalized Tobit Models," The Review of Economics and Statistics, MIT Press, vol. 96(2), pages 371-375, May.
    12. Kaushik Ghosh & Irina Bondarenko & Kassandra L Messer & Susan T Stewart & Trivellore Raghunathan & Allison B Rosen & David M Cutler, 2020. "Attributing medical spending to conditions: A comparison of methods," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-17, August.
    13. Mocan, H. Naci & Tekin, Erdal & Zax, Jeffrey S., 2004. "The Demand for Medical Care in Urban China," World Development, Elsevier, vol. 32(2), pages 289-304, February.
    14. Amanda Kowalski, 2016. "Censored Quantile Instrumental Variable Estimates of the Price Elasticity of Expenditure on Medical Care," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 34(1), pages 107-117, January.
    15. Galama, T. & Hullegie, P. & Meijer, E. & Outcault, S., 2012. "Empirical evidence for decreasing returns to scale in a health capital model," Health, Econometrics and Data Group (HEDG) Working Papers 12/05, HEDG, c/o Department of Economics, University of York.
    16. Galina Besstremyannaya, 2012. "Estimating income equity in social health insurance system," Working Papers w0172, Center for Economic and Financial Research (CEFIR).
    17. Marjan Petreski & Nikica Blazevski & Blagica Petreski, 2014. "Gender Wage Gap when Women are Highly Inactive: Evidence from Repeated Imputations with Macedonian Data," Journal of Labor Research, Springer, vol. 35(4), pages 393-411, December.
    18. Catalina Amuedo-Dorantes & Susan Pozo, 2011. "New evidence on the role of remittances on healthcare expenditures by Mexican households," Review of Economics of the Household, Springer, vol. 9(1), pages 69-98, March.
    19. Torrini, Irene & Grassetti, Luca & Rizzi, Laura, 2023. "Under-spending, over-spending or substitution among services? Spatial patterns of unexplained shares of health care expenditures," Health Policy, Elsevier, vol. 137(C).
    20. Frank, Richard G. & Glazer, Jacob & McGuire, Thomas G., 2000. "Measuring adverse selection in managed health care," Journal of Health Economics, Elsevier, vol. 19(6), pages 829-854, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bpj:fhecpo:v:14:y:2011:i:2:n:8. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.