The PRICE clinic for low-income elderly: a managed care model for implementing pharmacist-directed services. J Manag Care Pharm
Bibliographic record
Abstract
he elderly are particularly burdened by rising pharmaceutical costs, which grew to $162.4 billion in 2002, an overall increase of 15%.1 Older patients suffer from high rates of chronic disease, and ongoing drug therapy is often essential.2 Thus, most elderly people must adhere to multiple drug regimens. A study of adults older than 60 years found that these individuals take an average of 5 prescription medications per day, 3 times as many as the general population.3,4 Drug expenditures reflect this high use, as elderly patients incurred, on average, $2,322 in drug costs in 2003, of which $999 was paid out of pocket (OOP).5 Drug spending shows no signs of slowing, and in 2006, Medicare beneficiaries are expected to incur an average of $3,160 in annual drug expenditures, of which $1,454 (46%) will be paid OOP.5 Because nearly a quarter of Medicare recipients live on less than $600 per month, increasing drug e x p e n d i t u res impose a particularly heavy burden on low-income elderly people.6 In a survey of 10,416 elderly patients, 22 % of respondents stated that they skipped prescription doses or did not buy the medications they needed because the cost was too high.7 Another study found that two thirds of 660 chronically ill, older adults cut back on their prescription drugs because of difficulty paying for them, but they did not tell their doctors before they did so; furthermore, 35 % never told their doctors.8 The Medicare Modernization Act of 2003 is intended to help elderly patients aff o rd the rising costs of drugs. The legislation, which will cost an estimated $724 billion over 10 years, will offer a drug benefit package and subsidize the participation of health maintenance organizations (HMOs) and other private entities in the Medicare market.9, 1 0 The govern m e n t
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.026 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".