| Health insurance instability is a prevalent phenomenon in the United States. The objectives of this study were (i) to document the prevalence of prescription insurance instability among working age adults, (ii) to describe the association between prescription drug insurance instability and demographic, socioeconomic status and employment characteristics and (iii) to describe how prescription drug coverage instability impact medication use in individuals with: hypertension, diabetes and hyperlipidemia, The data source used in this study was the 2000 Medical Expenditure Panel Survey (MEPS) National Drug Codes (NDCs) from the Medispan database used to identify the drugs used to treat the three different chronic conditions. Bivariate and hierarchical multinomial logistic regression analyses were used to describe the associations among (1) demographics, (2) socioeconomic status, (3) employment characteristics and drug insurance status (classified as continuous, absent, or unstable). During the year 2000, 12.5% (21.1 million) of the working age adults in the United States had unstable prescription drug coverage. Adults who were unstably employed during the year and/or who worked for small firms generally experienced higher rates of drug insurance instability. Prescription drug insurance instability is a prevalent phenomenon among working age adults in the U.S., with approximately one in eight experiencing this problem during 2000. Results suggest that demographics, socio-economic status and employment characteristics all play important roles in predicting prescription drug insurance status, with the least educated and poorest being particularly vulnerable to interruptions in drug coverage. Life changing events, such as changes in marital status or employment, are important predictors of drug insurance instability. People with low or middle income group were 298% more likely to go without any lipid lowering medications purchase compared to those of the same income but stable insurance. People from the west seem to be using less medication for a chronic condition like diabetes. Since income is also an important predictor for the access of medications for chronic conditions, policies could target these high-risk groups in order to provide them with stable health insurance coverage. |
