Self-reported health status, prophylactic medication use, and healthcare costs in older adults with XXXX .

@entity1 @entity565 @entity308
OBJECTIVES: To examine the relationship between self-reported health status, prophylactic medication use, and healthcare service use in older adults with @entity565 . DESIGN: A prospective longitudinal cohort study was conducted over a 2-year postenrollment period in a population of asthmatic older adults enrolled in managed care. @entity1 completed a comprehensive health-risk screen at time of enrollment in the plan. SETTING: A Medicare health maintenance organization (HMO) in the southeastern United States with prescription benefit. @entity1 : One hundred twenty-nine older adults with @entity565 using inhaled corticosteroid therapy as prophylaxis and enrolled in a Medicare HMO were available for complete follow-up. MEASUREMENTS: We measured self-reported health perception, falls, lifestyle, @entity308 symptomatology, and pre-enrollment healthcare service use using a comprehensive risk screen. We used the Med-Total index and total annual healthcare charges as measures of postenrollment inhaled corticosteroid and healthcare service use. RESULTS: After adjusting for the effects of other variables, we found that @entity308 symptomatology at baseline and increased comorbidity severity (using the Charlson comorbidity index) were associated with significant reductions in prophylactic medication possession (27% with @entity308 symptomatology and 6% with unit increase in Charlson's index, P <.05). Additionally, after adjusting for the effects of baseline health status, we found that a 10% increase in prophylactic medication possession was associated with a nearly 5% decrease in total annual healthcare charges in this population (P <.01). CONCLUSION: There are strong but not fully explained associations between @entity308 symptoms at time of enrollment, decreased postenrollment prophylactic medication use and increased postenrollment healthcare service use in older adults with @entity565 .
