Perceived barriers to healthcare and receipt of recommended medical care among elderly Medicare beneficiaries. Arch Gerontol Geriatr 2017 Sep;72:45-51
Date
05/26/2017Pubmed ID
28544946Pubmed Central ID
PMC5522756DOI
10.1016/j.archger.2017.05.007Scopus ID
2-s2.0-85019949362 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
PURPOSE: Many Medicare beneficiaries perceive barriers to receiving healthcare, although the consequences are unknown. Facilitators can aid in the receipt of healthcare services. The objective was to assess the relationship between perceived facilitators and barriers to healthcare and actual receipt of recommended medical care among elderly beneficiaries.
METHODS: A cohort study using data from the 2001-2008 entry panels of the Medicare Current Beneficiary Survey that included 24,607 community-dwelling beneficiaries 65 years of age and older. Surveys elicited perceptions of healthcare with respect to: care coordination and quality; access to medical care; getting or delaying healthcare because of financial reasons; transportation; and usual source of care. The outcome was receipt of recommended medical care, expressed as an aggregate of 38 indicators covering initial evaluation, diagnostic tests, therapeutic interventions, hospitalization follow-up, and routine preventive care. Multivariable survey logistic regression produced odds ratios (ORs) and 95% confidence intervals (CIs) for receipt of recommended medical care, adjusted for sociodemographics, insurance, comorbidities, and disability.
RESULTS: Beneficiaries who reported having trouble getting or reported delaying healthcare because of financial reasons (barrier) (adjusted OR=0.79, 95% CI: 0.73-0.86) and those who reported having no usual source of care (facilitator) (adjusted OR=0.55, 95% CI: 0.48-0.63) were less likely to receive recommended medical care.
CONCLUSIONS: Survey data that capture patient perceptions of facilitators and barriers to healthcare may be useful for identifying system factors that affect timely receipt of recommended medical care. This information can inform the design of policies and programs to improve the healthcare of older adults.
Author List
Kurichi JE, Pezzin L, Streim JE, Kwong PL, Na L, Bogner HR, Xie D, Hennessy SAuthor
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Cohort Studies
Female
Health Services Accessibility
Humans
Logistic Models
Male
Medicare
Patient Acceptance of Health Care
Perception
United States
