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Kuye, Ifedayo

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Kuye, Ifedayo

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Author's Publications: search.filters.isAuthorOfPublication.167531a2-3ad1-4e94-bb09-9bf0e5e01f72

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    Use of Health Care Resources and Costs After Patient Nonattendance in Dermatology
    (American Medical Association (AMA), 2016) Halim, Kareem; Weng, Qing Yu; Kuye, Ifedayo; Joyce, Cara; Mostaghimi, Arash
    Patient nonattendance occurs when patients miss appointments without notifying their health care professionals in advance. In dermatology, nonattendance rates range from 7.8% to 31.0% of scheduled appointments. The consequences of nonattendance range from compromised care to wasted appointment slots, decreased efficiency, and diluted residency training. We seek to define the effect of nonattendance on subsequent use of health care resources and health care spending in dermatology.
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    Cognition and the Take-Up of Subsidized Drug Benefits by Medicare Beneficiaries
    (2016-05-17) Kuye, Ifedayo
    Importance: Take-up of the Medicare Part D low-income subsidy (LIS) by eligible beneficiaries has been low despite the attractive drug coverage it offers at no cost to beneficiaries and outreach efforts by the Social Security Administration. Objective: To examine the role of beneficiaries’ cognitive abilities in explaining this puzzle. Design and Setting: Analysis of survey data from the nationally representative Health and Retirement Study. Participants: Elderly Medicare beneficiaries who were likely eligible for the LIS, excluding Medicaid and Supplemental Security Income recipients, who automatically receive the subsidy without applying. Main Outcomes and Measures: Using survey assessments of cognition and numeracy from 2006-2010, we examined how cognitive abilities were associated with self-reported Part D enrollment, awareness of the LIS, and application for the LIS. We also compared out-of-pocket drug spending and premium costs between LIS-eligible beneficiaries who did and did not report receipt of the LIS. Analyses were adjusted for sociodemographic characteristics, household income and assets, health status, and presence of chronic conditions. Results: Compared with LIS-eligible beneficiaries in the top quartile of cognition, those in the bottom quartile were significantly less likely to report Part D enrollment (adjusted rate, 63.5% vs. 52.0%; P=0.002), LIS awareness (58.3% vs. 33.3%; P=0.001), and LIS application (25.5% vs. 12.7%; P<0.001). Lower numeracy was also associated with lower rates of Part D enrollment (P=0.03) and LIS application (P=0.002). Reported receipt of the LIS was associated with significantly lower annual out-of-pocket drug spending (adjusted mean difference, −$256; P=0.02) and premium costs (−$273; P=0.02). Conclusions and Relevance: Among Medicare beneficiaries likely eligible for the Part D LIS, poorer cognition and numeracy were associated with lower reported take-up. Current educational and outreach efforts encouraging LIS applications may not be sufficient for beneficiaries with limited abilities to process and respond to information. Additional policies may be needed to extend the financial protection conferred by the LIS to all eligible seniors