To compare health maintenance procedure rates of Medicare patients with different levels of disability.
Observational study analyzing data from the 1995 Medicare Current Beneficiary Survey (MCBS, n=15,590).
Self-reported Pap smears, mammograms, and influenza and pneumococcal vaccinations were compared between groups with different levels of health-related difficulties in six activities of daily living (ADL).
Compared to those without disabilities, the most severely disabled women (limitations in 5 or 6 ADL) reported fewer Pap smears (age <= 70,23% vs 41%, p<. 001) and mammograms (age >= 50,13% vs 44%, p<. 001).
In a controlled analysis, individuals with this high level of disability were 57% (95% confidence interval [CI], 33% to 72%) and 56% (95% CI, 43% to 76%) less likely to report receiving Pap smears and mammograms, respectively, compared with ablebodied women, regardless of their age, whether they were in an HMO, or whether they lived in a long-term care facility.
Functional limitations were not a deterrent to receiving vaccinations.
In general, patients in HMOs reported more procedures than those in fee-for-service, while those in long-term care facilities reported fewer procedures than those living in the community.
Disability among Medicare patients is a significant, independent risk factor for not receiving mammograms and Pap smears. (...)
Mots-clés Pascal : Malade, Handicap, Indice gravité, Attribution, Soin intégré, Prévention, Incidence, Epidémiologie, Homme
Mots-clés Pascal anglais : Patient, Handicap, Severity score, Attribution, Managed care, Prevention, Incidence, Epidemiology, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0335912
Code Inist : 002B30A03B. Création : 16/11/1999.