title: Preventive services among Medicare beneficiaries with supplemental coverage versus HMO enrollees, medicaid recipients, and elders with no additional coverage.
abstract: BACKGROUND
  Studies conducted when Medicare began to cover preventive services, found that beneficiaries with supplemental insurance were much more likely to have such services than those without additional coverage.
  
  
  OBJECTIVE
  To examine preventive services among Medicare beneficiaries with supplemental insurance, Medicaid, health maintenance organization (HMO) enrollees, and those without additional insurance.
  
  
  METHODS
  Analysis of the 1996 Medical Expenditure Panel Survey, a nationally representative multistage survey.
  
  
  METHODS
  2,251 persons aged 65 and older with Medicare coverage.
  
  
  METHODS
  Self-reported preventive services, specifically, blood pressure measurement, cholesterol testing, influenza vaccination, mammography, Papanicolau (Pap) testing, and breast and prostate examinations. Multivariate modeling was used to adjust for age, education, race/ethnicity, and functional status.
  
  
  RESULTS
  Elders without additional coverage were approximately 10% points less likely to have influenza vaccination, cholesterol testing, mammography, or Pap smears than those with supplemental coverage (P < 0.05). Multivariate adjustment attenuated some of these differences with age and education being the most important predictors of having preventive services. HMO enrollees were more likely to have mammograms than those with supplemental coverage (P < 0.05).
  
  
  CONCLUSIONS
  Several years after Medicare extended coverage to include preventive services, differences in utilization of such services among elders with and without supplemental insurance have narrowed substantially.
authors.affiliation: Division of General Medicine and the Center for Active Life of Minority Elders, Columbia Presbyterian Medical Center, New York, New York, USA. carraso@medicinel.cpmc.columbia.edu
authors.forename: O
authors.initials: O
authors.lastname: Carrasquillo
authors.forename: R A
authors.initials: RA
authors.lastname: Lantigua
authors.forename: S
authors.initials: S
authors.lastname: Shea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D007407:Interviews as Topic; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D016345:Medicare Part B / Q000706:statistics & numerical data*; D020398:Medicare Part C / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014600:Utilization Review