CERGAS Seminar "Older Patients and Geographic Barriers to Pharmacy Access: When Non-adherence Translates to an Increased Use of Other Components of Health Care"
Milano - Via Bocconi 8, Room 06
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This study develops and
applies a Grossman-style health production model to explain whether
geographic barriers can influence non-adherence to prescription drugs,
as well as the use of other components of health
care, as a potential substitute for drug compliance, and their effect
on patients’ health. To test the theoretical hypothesis, 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 not only
longer distance
to reach drug providers but also “pharmacy desert” negatively influence
patients’ adherence. According to our results, patients’ non-adherence
to pharmacological therapy is responsible for an increased probability
of patients’ post-discharge
mortality and the overuse of other medical services, namely
hospitalizations and emergency department visits. Non-adherence may thus
represent a potential source of waste for the health care system.