Parchman ML; Association for Health Services Research. Meeting.

Abstr Book Assoc Health Serv Res Meet. 1999; 16: 365.

University of Texas Health Sciences Center, San Antonio 78284, USA.

RESEARCH OBJECTIVE: Medicare beneficiaries now have multiple health plan choices available to them. Understanding how primary care is delivered to Medicare beneficiaries in these new health care systems, and its impact on quality of care is important. The purpose of this study is to determine the relationship between traditional measures of quality and the attributes of primary care in a nationally representative sample of Medicare beneficiaries. STUDY DESIGN: Data are from the 1992 Medicare Current Beneficiary Survey, a longitudinal survey of a representative sample of Medicare beneficiaries (n=11,817). The survey evaluated beneficiary access, satisfaction, utilization and health care expenses. A core set of primary care attributes: access, comprehensiveness of care, accumulated knowledge of the patient, interpersonal communication, and longitudinal care were determined using survey responses to questions in each area. Quality of care was measured by assessing the delivery of four preventive services commonly used in quality assessments: a flu shot this past winter, a pap smear in the past year if no hysterectomy, a mammogram in the past year for women under the age of 75, and smoking cessation. PRINCIPAL FINDINGS: Scores for accumulated knowledge of the patient were associated with three of the four preventive services: receiving a flu shot, smoking cessation and mammograms. Comprehensiveness of care scores and communication scores were associated with two preventive services: smoking cessation and mammograms. Longitudinal care was related to receiving a flu shot, and access to care was related to pap smears. CONCLUSIONS: Quality of care for Medicare beneficiaries may be significantly related to the attributes of primary care, especially their accumulated knowledge of the patient over time and the comprehensiveness of care delivered by the primary care provider. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: If established patient-provider relationships are disrupted, especially if the disruption causes a loss of accumulated knowledge of the patient or inability of the patient to get most of their care at the same location, quality of care for Medicare beneficiaries may suffer.

Publication Types:

• Meeting Abstracts

Keywords:

• Communication
• Female
• Humans
• Longitudinal Studies
• Medicare
• Medicare Part C
• Population
• Population Groups
• Primary Health Care
• economics
• hsrmtgs

Other ID:

• HTX/20603027

UI: 102194716

From Meeting Abstracts