The types of drugs that Medicare patients are prescribed varies widely, depending on where they live, according to a recent study.
Dr. Jeffrey Munson, lead author of the Dartmouth Atlas Project's study, said data show several examples of how the type of care Medicare patients receive varies from region to region, without obvious reasons why the variation exists.
For example, heart attack victims living in Ogden, Utah, are twice as likely to receive medicine to lower their cholesterol and their risk of another heart attack than those in Abilene, Texas, Munson said. Meanwhile, in Oklahoma, heart attack victims in northeast Oklahoma were most likely to receive this type of medication, according to the study.
“I think it's really important that we try to understand why these variations exist and why it is that in some regions of the country, 90 percent of heart attack survivors are getting effective care, but in other regions, only 60 percent of the same patients are getting effective care,” Munson said. “It's not obvious why that would be.”
Munson recently answered questions about the study and the implications it has.
Q: Oklahoma has some of the worst health rankings in the nation. How does that relate to the amount of high-risk drugs being prescribed?
A: Researchers at Dartmouth looked at how the use of high-risk medications varies across the U.S. High-risk medications are defined as drugs that “have significant rates of adverse effects when used in older patients, and the magnitude of the expected benefit generally does not outweigh these risks,” according to the study.
Oklahoma had one of the highest rates of Medicare patients being prescribed at least one high-risk medication. For example, one in three residents living in western Oklahoma, excluding the Oklahoma Panhandle, were prescribed at least one high-risk medication. The same was true for residents in parts of southeast Oklahoma.
Meanwhile, residents in the New England region were prescribed these types of medications at a much lower rate.
Oklahoma does have some of the worst health outcomes in the nation, with high rates of obesity, diabetes and heart disease — but that doesn't completely explain the variation, Munson said.
Munson said researchers use a formula to compare similarly sick patient populations, and when they compared those regions, they found there's still huge variation in who's being prescribed what drugs.