Accessing a new medication in Germany

A novel approach to assess a health insurance-related barrier

Karl J. Krobot, Jay S. Kaufman, Dale B. Christensen, John S. Preisser, William C. Miller, Michel Ibrahim

Research output: Contribution to journalArticle

Abstract

PURPOSE: Knowledge of the existence, position, and magnitude of barriers to equitable healthcare is an important consideration in shaping healthcare policies. METHODS: The authors developed a novel three-dimensional person-time-related hurdle model and followed a cohort of 7358 statutorily (SHI) and 457 privately health insured (PHI) patients with migraine headaches at 377 primary-care practices (MediPlus, IMS Health) in the second to fourth year of the HealthCare Structural Reform Act in Germany. RESULTS: For SHI compared with PHI migraine patients, there was a hurdle to receiving sumatriptan at all (2.4-fold lower hazard, 95% confidence interval, 1.8-3.2). Among patients who received sumatriptan, frequency and intensity of use differed only minimally between SHI and PHI patients. CONCLUSIONS: These findings have implications for healthcare researchers and healthcare policies. The framework extends traditional hurdle models and can serve as a model for quantifying barriers to receipt of services under different funding policies.

Original languageEnglish (US)
Pages (from-to)756-761
Number of pages6
JournalAnnals of Epidemiology
Volume15
Issue number10
DOIs
StatePublished - Nov 2005
Externally publishedYes

Fingerprint

Health Insurance
Germany
Delivery of Health Care
Sumatriptan
Health
Migraine Disorders
Health Care Reform
Primary Health Care
Research Personnel
Confidence Intervals

Keywords

  • Delivery of Healthcare
  • Epidemiologic Methods
  • Health Insurance

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Accessing a new medication in Germany : A novel approach to assess a health insurance-related barrier. / Krobot, Karl J.; Kaufman, Jay S.; Christensen, Dale B.; Preisser, John S.; Miller, William C.; Ibrahim, Michel.

In: Annals of Epidemiology, Vol. 15, No. 10, 11.2005, p. 756-761.

Research output: Contribution to journalArticle

Krobot, Karl J. ; Kaufman, Jay S. ; Christensen, Dale B. ; Preisser, John S. ; Miller, William C. ; Ibrahim, Michel. / Accessing a new medication in Germany : A novel approach to assess a health insurance-related barrier. In: Annals of Epidemiology. 2005 ; Vol. 15, No. 10. pp. 756-761.
@article{2485524cc2cf4de18cd40fe7222755c3,
title = "Accessing a new medication in Germany: A novel approach to assess a health insurance-related barrier",
abstract = "PURPOSE: Knowledge of the existence, position, and magnitude of barriers to equitable healthcare is an important consideration in shaping healthcare policies. METHODS: The authors developed a novel three-dimensional person-time-related hurdle model and followed a cohort of 7358 statutorily (SHI) and 457 privately health insured (PHI) patients with migraine headaches at 377 primary-care practices (MediPlus, IMS Health) in the second to fourth year of the HealthCare Structural Reform Act in Germany. RESULTS: For SHI compared with PHI migraine patients, there was a hurdle to receiving sumatriptan at all (2.4-fold lower hazard, 95{\%} confidence interval, 1.8-3.2). Among patients who received sumatriptan, frequency and intensity of use differed only minimally between SHI and PHI patients. CONCLUSIONS: These findings have implications for healthcare researchers and healthcare policies. The framework extends traditional hurdle models and can serve as a model for quantifying barriers to receipt of services under different funding policies.",
keywords = "Delivery of Healthcare, Epidemiologic Methods, Health Insurance",
author = "Krobot, {Karl J.} and Kaufman, {Jay S.} and Christensen, {Dale B.} and Preisser, {John S.} and Miller, {William C.} and Michel Ibrahim",
year = "2005",
month = "11",
doi = "10.1016/j.annepidem.2005.02.009",
language = "English (US)",
volume = "15",
pages = "756--761",
journal = "Annals of Epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - Accessing a new medication in Germany

T2 - A novel approach to assess a health insurance-related barrier

AU - Krobot, Karl J.

AU - Kaufman, Jay S.

AU - Christensen, Dale B.

AU - Preisser, John S.

AU - Miller, William C.

AU - Ibrahim, Michel

PY - 2005/11

Y1 - 2005/11

N2 - PURPOSE: Knowledge of the existence, position, and magnitude of barriers to equitable healthcare is an important consideration in shaping healthcare policies. METHODS: The authors developed a novel three-dimensional person-time-related hurdle model and followed a cohort of 7358 statutorily (SHI) and 457 privately health insured (PHI) patients with migraine headaches at 377 primary-care practices (MediPlus, IMS Health) in the second to fourth year of the HealthCare Structural Reform Act in Germany. RESULTS: For SHI compared with PHI migraine patients, there was a hurdle to receiving sumatriptan at all (2.4-fold lower hazard, 95% confidence interval, 1.8-3.2). Among patients who received sumatriptan, frequency and intensity of use differed only minimally between SHI and PHI patients. CONCLUSIONS: These findings have implications for healthcare researchers and healthcare policies. The framework extends traditional hurdle models and can serve as a model for quantifying barriers to receipt of services under different funding policies.

AB - PURPOSE: Knowledge of the existence, position, and magnitude of barriers to equitable healthcare is an important consideration in shaping healthcare policies. METHODS: The authors developed a novel three-dimensional person-time-related hurdle model and followed a cohort of 7358 statutorily (SHI) and 457 privately health insured (PHI) patients with migraine headaches at 377 primary-care practices (MediPlus, IMS Health) in the second to fourth year of the HealthCare Structural Reform Act in Germany. RESULTS: For SHI compared with PHI migraine patients, there was a hurdle to receiving sumatriptan at all (2.4-fold lower hazard, 95% confidence interval, 1.8-3.2). Among patients who received sumatriptan, frequency and intensity of use differed only minimally between SHI and PHI patients. CONCLUSIONS: These findings have implications for healthcare researchers and healthcare policies. The framework extends traditional hurdle models and can serve as a model for quantifying barriers to receipt of services under different funding policies.

KW - Delivery of Healthcare

KW - Epidemiologic Methods

KW - Health Insurance

UR - http://www.scopus.com/inward/record.url?scp=27644596730&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27644596730&partnerID=8YFLogxK

U2 - 10.1016/j.annepidem.2005.02.009

DO - 10.1016/j.annepidem.2005.02.009

M3 - Article

VL - 15

SP - 756

EP - 761

JO - Annals of Epidemiology

JF - Annals of Epidemiology

SN - 1047-2797

IS - 10

ER -