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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Annette L. Fitzpatrick, PhD, Department of Epidemiology, University of Washington, 600 Stewart Street, Suite 700, Seattle, WA 98101, 206-685-7123, fitzpal@u.washington.edu, Neil R. Powe, MD MPH MBA, Department of Epidemiology, Johns Hopkins University, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21205, Lawton S. Cooper, MD, MPH, Prevention Studies Research Group, National Heart, Lung, and Blood Institute, NIH, Division of Epidemiology and Clinical Applications, 6701 Rockledge Drive, Bethesda, MD 20892, Diane G Ives, MPH, Department of Epidemiology, University of Pittsburgh, 505 Parran Hall, Pittsburgh, PA 15261, and John A. Robbins, MD, Department of Internal Medicine, University of California, Davis, 2000 Stockton Blvd., Suite 200, Sacramento, CA 95817.
Many factors influence access to care for young populations but access has been understudied in older adults covered by Medicare. The Cardiovascular Health Study (CHS), a longitudinal cohort drawn from Medicare enrollment files in 1989, included self-administered questions on access and barriers to health care at its fifth annual examination (1993/94). The questions were completed by 4889 of 5364 (83.7%) living participants. Mean age of respondents was 76.0 years. Most respondents (87%) reported using a physician’s office for medical care. Only 3% sought care as “walk-in” rather than scheduling an appointment, and 42% were able to make a same-day appointment. Most (93%) regularly saw the same physician; over 87% had a doctor they could talk to on the telephone. The most common factors reported as affecting one’s ability to see a doctor were the doctor’s lack of responsiveness to concerns (3.9%), medical bills (2.7%), transportation (2.6%), and street safety (2.3%). In a multiple logistic regression model assessing independent determinants of access problems, participants earning less than $12,000 annually were 2.1 times (95% CI:1.6-2.7) more likely to report a barrier to seeing a doctor than those earning over $25,000. Individuals with no supplemental insurance (OR:1.3, 95% CI: 1.1- 1.7), minority race (OR:1.3, 95% CI: 1.03-1.7), over 85 years old (OR:1.5, 95% CI: 1.04-2.1), and females (OR:1.2, 95% CI: 1.02-1.5) were also more likely to report barriers to care. Certain groups of the elderly American population have problems with access to medical care and treatment even though they possess Medicare insurance.
Learning Objectives: At the conclusion of this session, the participant in this session will be able to
Keywords: Access and Services,
Related Web page: chs-nhlbi.org
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Cardiovascular Health Study, an NHLBI funded cohort of persons 65 and older designed to investigate risk factors for cardiovascular disease and other conditions of aging.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.