Does poorer familiarity with Medicare translate into worse access to health care?
OBJECTIVE
To examine the relationship between a global measure of Medicare program familiarity and a broad set of measures of actual and perceived healthcare access.


METHODS
Mailed survey in fall of 2004 (2,997 completed surveys; 53% response rate).


METHODS
Metropolitan and nonmetropolitan areas across the United States.


METHODS
White, black, and Hispanic Medicare beneficiaries.


METHODS
Familiarity with Medicare and self-reported measures of health status, healthcare use, and perceived access to care.


RESULTS
Reported poorer familiarity with Medicare is associated with a greater likelihood of delayed care due to cost, multiple emergency department visits, lack of prescription medication use, poorer perceived access to care, poorer overall health, and a greater reported decline in health from the prior year. Black and Hispanic respondents were more likely to be unfamiliar than whites, although the relationship between familiarity and healthcare access persisted after adjusting for race or ethnicity, Medicare health plan enrollment status, supplemental insurance status, age, sex, income level, education, geographic area, and general healthcare use.


CONCLUSIONS
Poorer familiarity with Medicare may affect beneficiaries' ability to access needed care effectively, may lead them to delay or avoid seeking care, and ultimately may have negatively affect the quality of the health care that they receive and their outcomes.
Morgan
Robert O
RO
Division of Management, Policy, and Community Health, School of Public Health, University of Texas, Houston, Texas, USA. Robert.O.Morgan@uth.tmc.edu
Teal
Cayla R
CR
Hasche
Jennifer C
JC
Petersen
Laura A
LA
Byrne
Margaret M
MM
Paterniti
Debora A
DA
Virnig
Beth A
BA
D000368:Aged; D032882:Comprehension; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D006278:Medicare; D021641:Recognition, Psychology; D012959:Socioeconomic Factors; D014481:United States