Using population-based data to examine preventive services by disability type among dually eligible (Medicare/Medicaid) adults

Details

• Alternative Title:
  Disabil Health J
• Personal Author:
  Reichard, Amanda ; Fox, Michael H.
• Description:
  Background
  
  Individuals dually eligible for Medicaid and Medicare constitute a small percentage of these program’s populations but account for a disproportionately large percent of their total costs. While much work has examined high expenditures, little is known about their health and details of their health care utilization.
  
  Objective/hypothesis
  
  Utilize an important public health surveillance tool to better understand preventive service use among the dual eligible population.
  
  Methods
  
  This study involved descriptive and regression analyses of dual eligibles in the Medical Expenditure Panel Survey data from pooled alternate years 2000–2008. We classified the sample into 4 mutually exclusive groups: cognitive limitations, physical disabilities, double diagnosis (cognitive limitations and physical disability), or neither cognitive limitations nor physical disability.
  
  Results
  
  For most groups, age was significantly associated with preventive services, though direction varies. Older age was linked to greater receipt of flu shots while younger age was associated with greater receipt of Pap tests, mammograms and dental services. Black women in all groups (except cognitive limitations) had an increased likelihood of receiving a Pap test and a mammogram.
  
  Conclusions
  
  A subset of dual eligibles drives the majority of expenditures. People with physical disabilities, regardless of whether they also have a cognitive limitation, are among the highest costing and sickest of our non-institutionalized dual eligible population. Efforts to understand and address the challenges faced by women with physical disabilities in accessing Pap tests or mammograms may be helpful in improving the overall health status for this disability group, but also for all dual eligibles.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Age Factors Black People Cognition Disorders Delivery Of Health Care Dental Care Diagnostic Services Disabled Persons Eligibility Determination Female Health Care Costs Health Care Surveys Humans Insurance Coverage Male Medicaid Medicare Middle Aged Preventive Health Services United States Vaccination Young Adult

  More +
• Keywords:
  Disability Dual Eligible Preventive Health Services
• Source:
  Disabil Health J. 2012; 6(2):75-86
• Pubmed ID:
  23507157
• Pubmed Central ID:
  PMC4478586
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; H133B110006/PHS HHSUnited States/ ; H133B060018/PHS HHSUnited States/
• Volume:
  6
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:78a561548f2ef8eabf272b59918c9e929448e8c9a32b29912fabef0d4405fd5e
• Download URL:
  https://stacks.cdc.gov/view/cdc/31745/cdc_31745_DS1.pdf
• File Type:
  [PDF - 3.18 MB ]