142nd APHA Annual Meeting and Exposition

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302925
Relationship between Disability and Patient Satisfaction with Health Plan, Personal Doctor, and Overall Care among Adult Medicaid Beneficiaries

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Cilia Zayas, MHA , Department of Health Services Research Management and Policy, University of Florida, Gainesville, FL
Jessica Schumacher, PhD
Allyson Hall, PhD , College of Public Health & Health Professions, University of Florida, Gainesville, FL
Sarah Bauer, MPH , College of Public Health & Health Professions, University of Florida, Gainesville, FL
Claudia Tamayo, MPH , College of Public Health and Health Professions, University of Florida, Gainesville, FL
Susan Redmon
Background: The purpose of this study was to assess the relationship between disability and satisfaction with a patient’s health plan, personal doctor, and overall care among adult Medicaid beneficiaries (18-55+) and assess whether observed differences can be explained by patient demographics or experiences with care received.

Methods: The study included adult respondents to the Florida Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS v4), a telephone survey conducted between April-June 2013 (n=374). Using a 10-point scale, beneficiaries with a usual provider were asked to rate their satisfaction with their overall care, provider, and health plan. Additionally, beneficiaries were asked to rate whether they experienced one of 8 health care access difficulties in the previous 12 months (yes/no): including getting into the building, or communicating with doctor. Weighted multivariable linear regression analysis controlling for age, gender, race/ethnicity, and education was used to assess the relationship between disability and satisfaction, first excluding, then including experiences with care.  

Results: Findings suggest a statistically signficant relationship between disability status and health plan satisfaction (β=-0.71, 95% CI=-1.35, 0.06) but not satisfaction with overall care (β=-0.21, 95%CI=-0.95 -0.53) or personal doctor (β=0.11, 95%CI=-0.62, 0.83). After including patient health care experiences in the model, the relationship between disability and satisfaction with health plan was no longer significant (β=-0.10, 95%CI= -0.81-0.61).

Conclusions:  There was no difference in satisfaction between people with or without disabilities, with the exception of health plan rating. The observed effect of disability on health plan satisfaction can be explained by health care experiences.

Learning Areas:

Diversity and culture
Provision of health care to the public

Learning Objectives:
Assess the relationship between Disability Status and Consumer Assessment of Healthcare Providers and Systems (CAHPS) Ratings of Care, among adult Medicaid Beneficiaries. Discuss the impact of patient demographics and health care experiences on satisfaction ratings for a patient's health plan, usual provider, and overall healthcare received, from the perspective of an individual with a reported disability. Describe how negative experiences with care can disproportionately impact the overall quality of care for individuals living with a disability.

Keyword(s): Disabilities, Accessibility

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health services research doctoral student at the University of Florida. I performed these analyses under the supervision of my faculty mentors. I hold Masters degrees in Health Administration and Finance.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.