TRICARE Senior Pharmacy Program: Investigating the choice of prescription drug coverage among Medicare-eligible military retirees.

摘要

On April 1, 2001, the Department of Defense began offering prescription drug coverage to Medicare-eligible military retirees through a program called the TRICARE Senior Pharmacy Program (TSPP). The purpose of this study was to examine characteristics associated with the decision of Medicare-eligible military retirees to use or not use the TRICARE Senior Pharmacy Program. A secondary objective was to explore the reasons that the retirees selected for choosing to use or not to use the TSPP.; A cross-sectional, descriptive survey design was used. Data were collected by means of a mailed, self-administered survey sent to groups of users and non-users of the TSPP residing in a six-state area (Illinois, Indiana, Iowa, Michigan, Minnesota and Wisconsin). The status of the retiree regarding the TSPP (user vs. non-user) was determined prior to mailing the survey instrument so it could be tailored to collect more precise information from the two different groups. The dependent variable was the retiree's choice to use or not use the TSPP. Independent variables included factors from four domains: information about the retiree's previous/current medical care/prescription drug insurance, information about the retiree's current use of prescription drugs, attitudes about formal medical care, and demographic characteristics. Data were analyzed in several stages, including cross-classification of individual characteristics by the retiree's decision to use or not use the TSPP and logit regression models using the retiree's decision as the dependent variable and the retiree's characteristics as independent variables.; The usable response rate to the survey was 62.6%. The amount of a retiree's savings in out-of-pocket payment for prescription drugs, and their previous/current prescription insurance status, level of financial assets and number of reported chronic conditions were the hypothesized factors that were associated with the retiree's decision. Other factors that were significantly associated with the retiree's decision were gender, ethnicity and marital status. Not having prescription drug insurance also was positively associated with using TSPP.; Economic factors were chosen as important reasons for using TSPP by the majority of the respondents, verifying that prescription insurance status was an important factor. There was a small subgroup of retirees who were not informed about TSPP, although the cause for this was not determined.; Overall, the results suggest TSPP is satisfying a previously unmet need for prescription drug insurance on the part of this group of retirees. Future research should examine how closely this group of retirees mirrors that of the general elderly population and if this need is present in that population as well. The TSPP could serve as a model upon which to base any future Medicare prescription drug plans if this population closely resembles the general elderly population.