Evidence map›Paper›PMID 28544946›Full record

ArticleArchives of gerontology and geriatrics2017

Perceived barriers to healthcare and receipt of recommended medical care among elderly Medicare beneficiaries.

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

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of gerontology and geriatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing 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

10 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

8 authors.

Jibby E KurichiDepartment of Biostatistics and Epidemiology, The Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: jkurichi@mail.med.upenn.edu.
Liliana 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.
Joel E StreimGeriatric Psychiatry Section of the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; VISN 4 Mental Illness Research Education and Clinical Center (MIRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA. Electronic address: Joel.Streim@uphs.upenn.edu.
Pui L KwongDepartment of Biostatistics and Epidemiology, The Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: luikwong@mail.med.upenn.edu.
Ling NaDepartment of Biostatistics and Epidemiology, The Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: lingna@mail.med.upenn.edu.
Hillary R BognerDepartment of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: Hillary.Bogner@uphs.upenn.edu.
Dawei XieDepartment of Biostatistics and Epidemiology, The Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: dxie@mail.med.upenn.edu.
Sean HennessyDepartment of Biostatistics and Epidemiology, The Center 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. Electronic address: hennessy@upenn.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

purposeMany Medicare beneficiaries perceive barriers to receiving healthcare, although the consequences are unknown. Facilitators can aid in the receipt of healthcare services. The objective was to assess the relationship between perceived facilitators and barriers to healthcare and actual receipt of recommended medical care among elderly beneficiaries.

methodsA cohort study using data from the 2001-2008 entry panels of the Medicare Current Beneficiary Survey that included 24,607 community-dwelling beneficiaries 65 years of age and older. Surveys elicited perceptions of healthcare with respect to: care coordination and quality; access to medical care; getting or delaying healthcare because of financial reasons; transportation; and usual source of care. The outcome was receipt of recommended medical care, expressed as an aggregate of 38 indicators covering initial evaluation, diagnostic tests, therapeutic interventions, hospitalization follow-up, and routine preventive care. Multivariable survey logistic regression produced odds ratios (ORs) and 95% confidence intervals (CIs) for receipt of recommended medical care, adjusted for sociodemographics, insurance, comorbidities, and disability.

resultsBeneficiaries who reported having trouble getting or reported delaying healthcare because of financial reasons (barrier) (adjusted OR=0.79, 95% CI: 0.73-0.86) and those who reported having no usual source of care (facilitator) (adjusted OR=0.55, 95% CI: 0.48-0.63) were less likely to receive recommended medical care.

conclusionsSurvey data that capture patient perceptions of facilitators and barriers to healthcare may be useful for identifying system factors that affect timely receipt of recommended medical care. This information can inform the design of policies and programs to improve the healthcare of older adults.

Indexed as

Health Services AccessibilityMedicareAgedAged, 80 and overCohort StudiesFemaleHumansLogistic ModelsMalePatient Acceptance of Health CarePerceptionUnited StatesBarriers to healthcareElderlyFacilitators to healthcareMedicare

Identifiers

PMID28544946
PMCPMC5522756

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.