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Older patients and geographic barriers to pharmacy access: When nonadherence translates to an increased use of other components of health care

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  • Cinzia Di Novi
  • Lucia Leporatti
  • Marcello Montefiori

Abstract

This paper studies whether geographic barriers can influence nonadherence to prescription drugs and its effect on patients' health. We used a multivariate probit model estimated by maximum simulated likelihood that considers individual unobserved heterogeneity, which may characterize the relationship between adherence, medical care utilization, and health outcome. We used administrative data from Liguria, Italy, the region with the highest rate of individuals over the age of 65 in Europe. Our sample included older individuals affected by cardiovascular diseases, which remain one of the leading causes of death in most OECD countries. Our results showed that geographic barriers to pharmacies negatively influence patients' adherence. According to our results, patients' nonadherence to pharmacological therapy is responsible for an increased probability of patients' mortality and the overuse of other medical services, namely, hospitalizations and emergency department visits. Nonadherence may thus represent a potential source of waste for the health care system.

Suggested Citation

  • Cinzia Di Novi & Lucia Leporatti & Marcello Montefiori, 2020. "Older patients and geographic barriers to pharmacy access: When nonadherence translates to an increased use of other components of health care," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 97-109, October.
    • Handle: RePEc:wly:hlthec:v:29:y:2020:i:s1:p:97-109
    DOI: 10.1002/hec.4031
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    References listed on IDEAS

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    7. Cinzia Di Novi, 2010. "The influence of traffic‐related pollution on individuals' life‐style: results from the BRFSS," Health Economics, John Wiley & Sons, Ltd., vol. 19(11), pages 1318-1344, November.
    8. Di Novi, Cinzia, 2013. "The indirect effect of fine particulate matter on health through individuals’ life-style," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 44(C), pages 27-36.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 28th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-28 12:00:00

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    2. Joan Costa‐Font & Rosella Levaggi, 2020. "Innovation, aging, and health care: Unraveling “silver” from “red” herrings?," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 3-7, October.
    3. Luke Connelly & Gianluca Fiorentini & Marica Iommi, 2022. "Supply-side solutions targeting demand-side characteristics: causal effects of a chronic disease management program on adherence and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1203-1220, September.
    4. Di Novi, Cinzia & Leporatti, Lucia & Levaggi, Rosella & Montefiori, Marcello, 2022. "Adherence during COVID-19: The role of aging and socio-economics status in shaping drug utilization," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 1-14.
    5. Cinzia Di Novi & Matija Kovacic & Cristina Elisa Orso, 2023. "Online Health Information Seeking Behavior, Healthcare Access, and Health Status During Exceptional Times," Working Papers 2023: 26, Department of Economics, University of Venice "Ca' Foscari".
    6. Lucia Leporatti & Rosella Levaggi & Marcello Montefiori, 2021. "Beyond price: the effects of non-financial barriers on access to drugs and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 519-529, June.

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