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Longitudinal progression of cost-related medication non-adherence among Medicare patients with diabetes at high risk of hospitalization: The role of dual eligibility

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  • James X Zhang
  • David O Meltzer

Abstract

Objective: Little is known about the longitudinal progression of cost-related medication non-adherence (CRN) among the high-need, high-cost diabetes population. We aim to document the longitudinal aspect of CRN among Medicare diabetes patients at high risk of hospitalization and the role of Medicare-Medicaid dual eligibility in CRN. Research design and methods: 617 Medicare diabetes patients at high risk of hospitalization were followed up at 3-month intervals for a total of 16 surveys. Patients’ socio-demographic and health characteristics by dual eligibility were compared using Chi-square tests. The progression of CRN was documented using a Kaplan-Meier Survival Curve. A Cox Survival Regression analysis and a Generalized Estimating Equation (GEE) analysis were conducted to evaluate the adjusted hazard ratio (HR) and population-averaged effect of dual eligibility on CRN, controlling for socio-demographic and health characteristics. Results: 303 patients (49.1%) reported dual eligibility, among whom 151 (49.8%) reported CRN; they were more likely to be under 65 (p

Suggested Citation

  • James X Zhang & David O Meltzer, 2025. "Longitudinal progression of cost-related medication non-adherence among Medicare patients with diabetes at high risk of hospitalization: The role of dual eligibility," PLOS ONE, Public Library of Science, vol. 20(8), pages 1-11, August.
    • Handle: RePEc:plo:pone00:0329031
    DOI: 10.1371/journal.pone.0329031
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