Article

OBJECTIVE: To examine whether patient satisfaction and perceived quality of
medical care are related to stages of activity limitations among older adults.
DESIGN: Cross-sectional study. SETTING: Medicare Current Beneficiary Survey
(MCBS) for calendar years 2001 to 2011. PARTICIPANTS:
A population-based sample
(N=42,584) of persons aged >/=65 years living in the community. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: 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.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS