Although known primarily as health insurance for the elderly, the Medicare program provides health insurance coverage for a substantial number of people with disabilities. Medicare claims data provide an opportunity to better understand health services use by adults with disabilities. We examined physician visits among Medicare beneficiaries in two urban counties North Carolina (n=78,383). Medicare enrollment files were used to distinguish people enrolled due to age from those with disabilities. Enrollees were classified into four categories: persons with end-stage renal disease (ESRD); persons less than age 65 with a disability (Disabled <65); persons aged 65 and older but who were originally enrolled for disability reasons (Disabled >=65); and those eligible for Medicare because they are age 65or older (Aged >=65). 1998 physician claims for enrollees in the two counties were linked to physician files to determine physician specialty. Physician contact by Medicare enrollees was classified into three categories: primary care visits; visits to non-primary care physicians; and no physician visits during the calendar year. Rate ratios (RRs) and confidence intervals (95% CIs) were calculated to assess differences in physician visits between the enrollee groups. Disabled beneficiaries were less likely to visit a primary care provider (RR=0.69, 95% CI: 0.68-0.70) than older beneficiaries. Forty-two percent of disabled Medicare enrollees had no physician visit during the year. Variations in primary care use by demographic characteristics were also observed. These analyses suggest persons with disabilities, especially males and African Americans, are at risk of not receiving primary care services.
Learning Objectives: 1. Participants will learn about Medicare as a provider and potential data source for persons with disability. 2. Participants will understand use of primary care services by different groups of Medicare consumers.
Keywords: Primary Care, Medicare
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.