A new report released Oct. 15 from the Dartmouth Atlas Project shows that the use of both effective and risky drug therapies by Medicare patients varies widely across U.S. regions, offering further evidence that location is a key determinant in the quality and cost of the medical care that patients receive.
This first-ever report, “The Dartmouth Atlas of Prescription Drug Use,” offers an in-depth look at how prescription drugs are used by Medicare beneficiaries in the program’s Part D drug benefit, which had 37 million enrollees in 2012.
Dartmouth researchers found that the health status of a region’s Medicare population accounts for less than a third of the variation in total prescription drug use, and that higher spending is not related to higher use of proven drug therapies. The study raises questions about whether regional practice culture explains differences in the quality and quantity of prescription drug use.
The report separates the country into 306 regional healthcare markets and examines variations among them in the quantity and quality of prescription drug use, spending and use of brand name drugs. To examine the quality of care, the report looks at prescription use in three categories:
- Drug therapies proven to be effective for patients who have suffered heart attacks, have diabetes, or have broken a bone;
- Discretionary medications, which have less clear benefits, but may be effective for some patients who take them; and
- Potentially harmful medications where risks generally outweigh benefits.