Effects of utilization management on health outcomes: evidence from urinary tract infections and community-acquired pneumonia

References

• National Health Expenditure Data | CMS [Internet]. [cited 2021 Oct 20]. Available from: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData
   Google Scholar
• Park Y, Raza S, George A, et al. The effect of formulary restrictions on patient and payer outcomes: a systematic literature review. JMCP. 2017;23(8):893–901.
   PubMed Web of Science ®Google Scholar
• Soumerai SB, Zhang F, Ross-Degnan D, et al. Use of atypical antipsychotic drugs for schizophrenia in Maine Medicaid following a policy change. Health Aff. 2008;27:w185–w195.
   Web of Science ®Google Scholar
• Vogt WB, Joyce G, Xia J, et al. Medicaid cost control measures aimed at second-generation antipsychotics led to less use of all antipsychotics. Health Aff. 2011;30(12):2346–2354.
   Web of Science ®Google Scholar
• Chandra A, Gruber J, McKnight R. Patient cost-sharing and hospitalization offsets in the elderly. Am Econ Rev. 2010;100(1):193–213.
   PubMed Web of Science ®Google Scholar
• Gaynor M, Li J, Vogt WB. Substitution, spending offsets, and prescription drug benefit design. Forum Health Econ Policy. 2007;10(2). 10.2202/1558-9544.1084
   Google Scholar
• AHRQ - Quality Indicators [Internet]. [cited 2021 Oct 20]. Available from: https://qualityindicators.ahrq.gov/Archive/PQI_TechSpec_ICD10_v2018.aspx
   Google Scholar
• Arizpe A, Reveles KR, Aitken SL. Regional variation in antibiotic prescribing among medicare part D enrollees, 2013. BMC Infect Dis. 2016;16(1):1–6.
   PubMedGoogle Scholar
• Zhang Y, Lee BY, Donohue JM. Ambulatory antibiotic use and prescription drug coverage in older adults. Arch Internal Med. 2010;170(15):1308–1314.
   PubMedGoogle Scholar
• Capezuti EA, Malone ML, Khan A, et al. The encyclopedia of elder care: the comprehensive resource on geriatric health and social care. New York, NY: Springer Publishing Company; 2017.
   Google Scholar
• Duggan M, Healy P, Morton FS. Providing prescription drug coverage to the elderly: america’s experiment with medicare Part D. J Econ Perspect. 2008;22(4):69–92.
   PubMed Web of Science ®Google Scholar
• Engelhardt GV, Gruber J. Medicare Part D and the financial protection of the elderly. American Economic Journal: Economic Policy. 2011;3:77–102.
   Web of Science ®Google Scholar
• Afendulis CC, He Y, Zaslavsky AM, et al., The impact of medicare Part D on hospitalization rates. Health Serv Res. 2011;46(4): 1022–1038.
   PubMed Web of Science ®Google Scholar
• Huh J, Reif J. Did Medicare Part D reduce mortality? J Health Econ. 2017;53:17–37.
   PubMed Web of Science ®Google Scholar
• Kaestner R, Schiman C, Alexander GC. Effects of prescription drug insurance on hospitalization and mortality: evidence from medicare Part D. Journal of Risk and Insurance. 2019;86(3):595–628
   Web of Science ®Google Scholar
• Diebold J. The effects of medicare part D on health outcomes of newly covered medicare beneficiaries. J Gerontol B. 2018;73:890–900.
   PubMed Web of Science ®Google Scholar
• Olesen SW, Barnett ML, MacFadden DR, et al. Trends in outpatient antibiotic use and prescribing practice among US older adults, 2011-15: observational study. Bmj. 2018;362. DOI:10.1136/bmj.k3155.
   Google Scholar
• Housten T, Brown AM. PH professional network: the burden of prior authorization for pulmonary hypertension medications: a practical guide for managing the process. Adv Pulm Hypertens. 2018;17(3):126–131.
   Google Scholar
• American Medical Association. 2018 AMA prior authorization (PA) physician survey. 2019
   Google Scholar
• Ketcham JD, Lucarelli C, Powers CA. Paying attention or paying too much in medicare Part D †. Am Econ Rev. 2015;105(1):204–233.
   PubMed Web of Science ®Google Scholar
• Stock J, Yogo M. Asymptotic distributions of instrumental variables statistics with many instruments. Identification and Inference for Econometric Models: Essays in Honor of Thomas Rothenberg. 2005;6:109–120.
   Google Scholar
• Angrist JD, Pischke J-S. Mostly harmless econometrics: an empiricist’s companion. 1st ed. Princeton, NJ: Princeton University Press; 2008.
   Google Scholar
• Berndt ER, Gibbons RS, Kolotilin A, et al. The heterogeneity of concentrated prescribing behavior: theory and evidence from antipsychotics. J Health Econ. 2015;40:26–39.
   PubMed Web of Science ®Google Scholar
• Crawford GS, Shum M. Uncertainty and learning in pharmaceutical demand. Econometrica. 2005;73(4):1137–1173.
   Web of Science ®Google Scholar
• Happe LE, Clark D, Holliday E, et al. A systematic literature review assessing the directional impact of managed care formulary restrictions on medication adherence, clinical outcomes, economic outcomes, and health care resource utilization. JMCP. 2014;20(7):677–684.
   PubMed Web of Science ®Google Scholar
• Yu H, Rubin J, Dunning S, et al. Clinical and economic burden of community‐acquired pneumonia in the medicare fee‐for‐service population. J Am Geriatr Soc. 2012;60(11):2137–2143.
   PubMed Web of Science ®Google Scholar
• Curns AT, Holman RC, Sejvar JJ, et al. Infectious disease hospitalizations among older adults in the United States from 1990 through 2002. Arch Internal Med. 2005;165(21):2514–2520.
   PubMedGoogle Scholar
• Campbell SM, Meyer JC, Godman B. Why compliance to national prescribing guidelines is important especially across sub-Saharan Africa and suggestions for the future. J Biomed Pharm Sci [Internet]. 2021;4. [cited 2022 Mar 2]. Available from: https://strathprints.strath.ac.uk/77229
   Google Scholar
• Niaz Q, Godman B, Campbell S, et al. Compliance to prescribing guidelines among public health care facilities in Namibia; findings and implications. Int J Clin Pharm. 2020;42(4):1227–1236.
   PubMed Web of Science ®Google Scholar
• Versporten A, Zarb P, Caniaux I, et al. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey. Lancet Glob Health. 2018;6(6):e619–e629.
   PubMed Web of Science ®Google Scholar
• MedPAC. Health care spending and the medicare program. Washington (D.C): Medicare Payments Advisory Commission; 2015.
   Google Scholar