Dissatisfaction with medical services among Medicare beneficiaries with disabilities.
OBJECTIVE
To test the hypothesis that Medicare beneficiaries who have difficulties performing activities of daily living (ADLs) are more likely to report dissatisfaction with their health care than those without ADL difficulties.


METHODS
Cross-sectional study.


METHODS
Sample from the 1998 Medicare Current Beneficiaries Survey.


METHODS
A population-based sample (N=19,650) of noninstitutionalized Medicare beneficiaries.


METHODS
Not applicable.


METHODS
Satisfaction with overall quality and 9 specific aspects of medical services received in the last year.


RESULTS
After adjusting for sociodemographic, behavioral, and system characteristics and compared with those without ADL difficulties, Medicare enrollees were more likely to report dissatisfaction with the overall quality of their health care as their number of activity restrictions increased (1-2 ADLs: odds ratio [OR]=1.5; 95% confidence interval [CI], 1.2-2.0; 3-4 ADLs: OR=1.7; 95% CI, 1.2-2.4; 5-6 ADLs: OR=1.9; 95% CI, 1.4-2.8). Analysis of satisfaction with the 9 specific aspects of care yielded similar results.


CONCLUSIONS
Disability is a significant independent risk factor for dissatisfaction with health care in the Medicare population. Efforts should be made to identify individuals with ADL difficulties and to improve their ease and convenience of getting to a doctor, the availability of care off hours, the access to specialists, and the follow-up care received.
Jha
Amitabh
A
Craig Hospital, Denver Health Medical Center, and Department of Rehabilitation Medicine, University of Colorado, Denver, CO 80110, USA. ajha@craighospital.com
Patrick
Donald L
DL
MacLehose
Richard F
RF
Doctor
Jason N
JN
Chan
Leighton
L
D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare / Q000592:standards*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D014481:United States