The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66539

Nancy A. Miller, PhD, Policy Sciences Graduate Program, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250, 410-455-3889, nanmille@umbc.edu

We interviewed an admissions cohort of working age individuals in 17 Maryland nursing homes. Participation in the admission decision making process was a key component of the interview. Of the 205 individuals we interviewed, 42 percent of participants were unable to identify the primary medical provider involved in the decision, while 24 percent could identify only by a role (e.g., the doctor; the insurance lady). We utilized an ordered probit to examine patient and hospital characteristics related to identification of the provider. Increasing age and disability program participation were negatively related to knowledge of the provider. Individuals who were quadreplegic or had a prior or current alcohol or drug problem were more likely to identify the provider. Among those individuals who could identify the provider by name or by role, patients who discussed the decision with a provider who was African American or female were more likely to know the name of the provider, as were individuals insured through Medicare. Those individuals who self reported a prior or current liver disease or who reported a prior or current stroke were less likely to know the name of the provider. Provider/patient knowledge and communication has been assoiated with improved patient compliance and satisfaction. Lack thereof has recently been hypothesized to be a contributor to racial disparities in health. These findings thus have important policy implications.

Learning Objectives:

• 1> To become aware of patient and provider characteristics related to knowledge of the medical decision maker in a nursing home admission decision.

Keywords: Communication, Long-Term Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.