Evidence map›Paper›PMID 27765676›Full record

ArticleDisability and health journal2017

Disability stage and receipt of recommended care among elderly medicare beneficiaries.

Ling Na, Sean Hennessy, Hillary R Bogner, Jibby E Kurichi, Margaret Stineman, Joel E Streim, Pui L Kwong, Dawei Xie, Liliana E Pezzin

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PubMed Full text at PMC Publisher
In one paragraph

Article in Disability and health journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ling NaCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Sean HennessyCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Pharmacoepidemiology Research and Training, University of Pennsylvania, Philadelphia, PA, USA.
Hillary R BognerDepartment of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.
Jibby E KurichiCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Margaret StinemanCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Joel E StreimGeriatric Psychiatry Section of the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Pui L KwongCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Dawei XieCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Liliana E PezzinCenter for Patient Care and Outcomes Research (PCOR), Medical College of Wisconsin, Milwaukee, WI, USA; Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: lpezzin@mcw.edu.

Funding

Ambulatory Care Access and QualityR01HD074756 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI HENNESSY, SEAN · 2013 to 2017
$2.0M
NICHD NIH HHS R01 HD074756
6 · The paper itself

Abstract

backgroundReceipt of recommended care among older adults is generally low. Findings regarding service use among persons with disabilities supports the notion of disparities but provides inconsistent evidence of underuse of recommended care.

objectiveTo examine the extent to which receipt of recommended care among older Medicare beneficiaries varies by disability status, using a newly developed staging method to classify individuals according to disability.

methodsIn a cohort study, we included community-dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Current Beneficiary Survey between 2001 and 2008. Logistic regression modeling assessed the association of receiving recommended care on 38 indicators across different activity limitation stages.

resultsNearly one out of every three elderly Medicare beneficiaries did not receive overall recommended care. Adjusted odds ratios (ORs) revealed a decrease in use of recommended care with increasing activity limitation stage. For instance, ORs (95% CIs) across mild, moderate, severe and complete limitation stages (stages I-IV) compared to no limitation (stage 0) in ADLs were 0.99 (0.94-1.05), 0.89 (0.83-0.95), 0.81 (0.75-0.89) and 0.56 (0.46-0.68). Disparities in receipt of recommended care by disability stage were most marked for care related to post-hospitalization follow-up and, to a lesser degree, care of chronic conditions and preventive care.

conclusionsElderly beneficiaries at higher activity limitation stages experienced substantial disparities in receipt of recommended care. Tailored interventions may be needed to reduce disparities in receipt of recommended medical care in this population.

Indexed as

Disability EvaluationHealthcare DisparitiesHealth ServicesHealth Services AccessibilityHealth StatusMedicarePersons with DisabilitiesActivities of Daily LivingAgedAged, 80 and overChronic DiseaseCohort StudiesHospitalizationHumansLogistic ModelsMobility LimitationActivity limitation stagesDisabilityHealth care qualityMedicareReceipt of recommended care

Identifiers

PMID27765676
PMCPMC5314984

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.