title: Chronic Conditions and Self-Reported Health in a Medicare Advantage Plan Population.
abstract: Self-reported changes in physical and mental health by members are an important dimension by which the quality of a Medicare Advantage (MA) plan is rated by the Centers for Medicare & Medicaid Services. To better target their interventions, MA plans need a better understanding of what observed characteristics-including clinical health conditions-predict self-reported changes in physical and mental health. This study explored how one MA plan's survey of participants' responses regarding changes in physical and mental health is associated with a set of chronic conditions as well as sociodemographic characteristics. Multinomial logistic regressions were used to examine the influence of 9 chronic conditions and age, sex, race, education, dual eligibility status (Medicare/Medicaid eligible), marital and living status, and assistance with survey completion on changes in patient-reported physical and mental health. Six conditions-dementia (P < 0.001), diabetes (P = 0.003), congestive heart failure (P = 0.002), cerebrovascular disease (P = 0.001), coronary artery disease (CAD) (P < 0.001), and rheumatoid arthritis (P < 0.001)-were associated with self-reported worsening of overall physical health. Four conditions-dementia (P < 0.002), diabetes (P = 0.047), CAD (P = 0.001), and decubitus ulcers (P = 0.033)-were associated with self-reported worsening of overall mental health. Females, married respondents, and those needing assistance with survey completion were more likely to report worsening of their mental health. Enrollees older than age 65 actually were less likely to report worsening of overall mental health. Findings provide insight into which members may be more susceptible to reporting that their physical or mental health is worsening.
authors.affiliation: 1 Peoples Health, Inc. , Metairie, Louisiana.
authors.forename: Barbara
authors.initials: B
authors.lastname: Guerard
authors.affiliation: 2 Department of Industrial Engineering, University of Miami , Coral Gables, Florida.
authors.forename: Vincent
authors.initials: V
authors.lastname: Omachonu
authors.affiliation: 3 Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham , Alabama.
authors.forename: S Robert
authors.initials: SR
authors.lastname: Hernandez
authors.affiliation: 4 Department of Health Care Organization and Policy, University of Alabama at Birmingham , Birmingham, Alabama.|5 Sen Consulting, Inc. , Loganville, Georgia .
authors.forename: Bisakha
authors.initials: B
authors.lastname: Sen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology; D002908:Chronic Disease / Q000453:epidemiology*; D003704:Dementia / Q000453:epidemiology / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D020398:Medicare Part C; D003668:Pressure Ulcer / Q000453:epidemiology / Q000503:physiopathology; D014481:United States