Negative Physical Symptoms for Medicare Beneficiaries: A Focus for Quality Improvement Programs

APHA Scientific Session and Event Listing

Beth Hartman Ellis, PhD, Mary Anne Hope, MS, David Drachman, PhD, and Laura Giordano, MBA. Surveys, Research & Analysis, Health Services Advisory Group, 1600 E. Northern Avenue, Phoenix, AZ 85020-3983, 602-665-6133, bellis@azqio.sdps.org

The Medicare Health Outcomes Survey (HOS) assesses the physical and mental health outcomes of the Medicare elderly enrolled in managed care in the United States, and is the first health outcomes assessment for the Medicare population. This research examines a new measure in the HOS, the number of unhealthy days reported per month, as it relates to depression, chronic conditions, and negative physical symptoms.

The Medicare HOS includes the SF-36, which is a widely used multi-purpose, short-form health survey. Additional questions regarding activities of daily living, chronic conditions, negative symptoms, and demographic information are included in the survey. The respondents in this study were 41,556 Medicare beneficiaries in Cohort VIII Baseline representing 166 managed care plans.

Clustering among health plans was tested with the intraclass correlation coefficient and found to be not significant. Collinearity was also tested and found to not be problematic. Multiple regression was then used to analyze physically and mentally unhealthy days. Predictors included depression, negative physical health symptoms, and individual chronic conditions. Because of the large sample size, an effect size criterion was used to assess statistical significance, and set at 0.5% for the contribution of variance for each predictor.

The findings indicate that depression, bodily pain, and urinary incontinence were the strongest predictors of unhealthy physical and mental days, and had a stronger effect than many of the individual chronic conditions.

Beneficiaries with depression, bodily pain, and urinary incontinence should be strongly considered as a focus for quality improvement programs.

Learning Objectives:

Learning Objectives

1.Describe the Medicare Health Outcomes Survey.
2.Identify the chronic conditions and negative physical symptoms that are predictive for unhealthy days in beneficiaries 65 and over.
3.List the negative symptoms that are most applicable for quality improvement programs.

Keywords: Health Care Managed Care, Medicare

Presenting author's disclosure statement:

Not Answered

Innovations in Long-term Care

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA