Health Care Service Use Among Elderly Seasonal Migrators

Details

• Personal Author:
  Abraham JM ; Dowd BE ; Jeffery MM ; Kane RL ; Meier SK ; Wolfson J ; Abraham JM ; Dowd BE ; Jeffery MM ; Kane RL ; Meier SK ; Wolfson J
• Description:
  Elderly seasonal migrators share time between homes in different states, presenting challenges for care coordination and patient attribution methods. Medicare has prioritized alternative payment models, putting health care providers at risk for quality and value of services delivered to their attributed patients, regardless of the location of care. Little research is available to guide providers and payers on the service use of seasonal migrators. The authors use claims data on fee-for-service (FFS) Medicare beneficiaries' locations throughout the year to (1) identify seasonal migrators and (2) describe the care they receive in each seasonal home, focusing on primary care and emergency department (ED) visits and the relationships between the two. In all, 5.5% of the Medicare aged FFS population were identified as seasonal migrators, with 4.1% following the traditional snowbird pattern of migration, spending warm months in the north and cold months in the south. Migrators had higher rates of ED visits and primary care treatable (PCT) ED visits than the nonmigratory groups, controlling for location, age, race, sex, Medicaid status, season, and comorbidities. They also had more visits with specialist physicians, more days with outpatient services, and more days seeing a physician in any setting. Having local primary care strongly reduced rates of both PCT ED visits and total ED visits for all migration categories, with the greatest reduction seen in PCT ED visits by migrators (local primary care was associated with a 58% reduction in PCT ED visits by snowbirds and a 65% reduction in PCT ED visits by other migrators). [Description provided by NIOSH]
• Subjects:
  Aging Emergency Responders Health Personnel Occupational Health Safety
• Keywords:
  Age Groups Author Keywords: Seasonal Migration Emergency Care Health Care Health Care Service Use Medical Treatment Medicare Physicians Seasonal Factors
• ISSN:
  1942-7891
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  District of Columbia ; Minnesota ; OSHA Region 3 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  415-421
• Volume:
  21
• Issue:
  5
• NIOSHTIC Number:
  nn:20064234
• Citation:
  Popul Health Manag 2018 Oct; 21(5):415-421
• Contact Point Address:
  Molly Moore Jeffery, PhD, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Policy and Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905
• Email:
  jeffery.molly@mayo.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Population Health Management
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:17f3960c98312e8bd4619c535dbcd65e983721a0b38929651101065014c6121f801745533343da95283ecaf4fd67035eb9a2f60e775f5fa7e2e737c1317ff670
• Download URL:
  https://stacks.cdc.gov/view/cdc/222735/cdc_222735_DS1.pdf
• File Type:
  [PDF - 115.51 KB ]