title: Patient Satisfaction and Perceived Quality of Care Among Older Adults According to Activity Limitation Stages.
abstract: OBJECTIVE
  To examine whether patient satisfaction and perceived quality of medical care are related to stages of activity limitations among older adults.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Medicare Current Beneficiary Survey (MCBS) for calendar years 2001 to 2011.
  
  
  METHODS
  A population-based sample (N=42,584) of persons aged ≥65 years living in the community.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  MCBS questions were categorized under 5 patient satisfaction and perceived quality dimensions: care coordination and quality, access barriers, technical skills of primary care physicians, interpersonal skills of primary care physicians, and quality of information provided by primary care physicians. Persons were classified into a stage of activity limitation (0-IV) derived from self-reported difficulty levels performing activities of daily living (ADL) and instrumental ADL.
  
  
  RESULTS
  Compared with older beneficiaries with no limitations at ADL stage 0, the adjusted odds ratios (ORs) for stage I (mild) to stage III (severe) for satisfaction with care coordination and quality ranged from .85 (95% confidence interval [CI], .80-.92) to .79 (95% CI, .70-.89). Compared with ADL stage 0, satisfaction with access barriers ranged from OR=.81 (95% CI, .76-.87) at stage I to a minimum of OR=.67 (95% CI, .59-.76) at stage III. Similarly, compared with older beneficiaries at ADL stage 0, perceived quality of the technical skills of their primary care physician ranged from OR=.87 (95% CI, .82-.94) at stage I to a minimum of OR=.81 (95% CI, .72-.91) at stage III.
  
  
  CONCLUSIONS
  Medicare beneficiaries at higher stages of activity limitation, although not necessarily the highest stage of activity limitation, reported less satisfaction with medical care.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: hillary.bogner@uphs.upenn.edu.
authors.forename: Hillary R
authors.initials: HR
authors.lastname: Bogner
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Heather F
authors.initials: HF
authors.lastname: de Vries McClintock
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Pharmacoepidemiology Research and Training, University of Pennsylvania, Philadelphia, PA.
authors.forename: Sean
authors.initials: S
authors.lastname: Hennessy
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Jibby E
authors.initials: JE
authors.lastname: Kurichi
authors.affiliation: Geriatric Psychiatry Section of the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA.
authors.forename: Joel E
authors.initials: JE
authors.lastname: Streim
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Liliana E
authors.initials: LE
authors.lastname: Pezzin
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Pui L
authors.initials: PL
authors.lastname: Kwong
authors.affiliation: Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Stineman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D017060:Patient Satisfaction; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014481:United States
keywords: Aged; Disabled persons; Medicare; Patient satisfaction; Rehabilitation