Abstract
Objective
To examine the association between activity limitation stages and patient satisfaction
and perceived quality of medical care among younger Medicare beneficiaries.
Design
Cross-sectional study.
Setting
Medicare Current Beneficiary Survey (MCBS) for calendar years 2001-2011.
Participants
A population-based sample (N=9323) of Medicare beneficiaries <65 years of age living
in the community.
Interventions
Not applicable.
Main Outcome Measures
MCBS questions were categorized under 5 patient satisfaction and perceived quality
dimensions: care coordination and quality, access barriers, technical skills of primary
care physician (PCP), interpersonal skills of PCP, and quality of information provided
by PCP. Persons were classified into an activity limitation stage (0-IV) which was
derived from self-reported difficulty performing activities of daily living (ADL)
and instrumental activities of daily living (IADL).
Results
Compared to beneficiaries with no limitations at ADL stage 0, the adjusted odds ratios
(95% confidence intervals) for stage I (mild) to stage IV (complete) for satisfaction
with access barriers ranged from 0.62 (0.53-0.72) at stage I to a minimum of 0.31
(0.22-0.43) at stage IV. Similarly, compared to beneficiaries at IADL stage 0, satisfaction
with access barriers ranged from 0.66 (0.55-0.79) at stage I to a minimum of 0.36
(0.26-0.51) at stage IV. Satisfaction with care coordination and quality and perceived
quality of medical care were not associated with activity limitation stages.
Conclusions
Younger Medicare beneficiaries with disabilities reported decreased satisfaction with
access to medical care, highlighting the need to improve access to health care and
human services and to enhance workforce capacity to meet the needs of this patient
population.
Keywords
List of abbreviations:
ADL (activities of daily living), IADL (instrumental activities of daily living), MCBS (Medicare Current Beneficiary Survey), PCP (primary care physician)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 11, 2018
Footnotes
Supported by a Patient-Centered Outcomes Research Institute Project program award no. AD-12-11-4567 and by the National Institutes of Health (grant no. R01HD074756).
Disclosures: none.
Identification
Copyright
© 2018 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine