(NP) The purpose of this study was to explain the relationship between health care delivery system organization and the health and functional status of the U.S. older adult population with chronic illnesses. Adjustments were made for population characteristics, community resources and utilization of health services. The study used a newly expanded Andersen and Aday Health System Model, a recently developed health outcomes classification scheme, and hierarchical multiple regression analysis. A nationally representative sample of 7,760 adults participated in a household panel survey (cummulative RR 69%)and were asked about resources, utilization, health status, and functional status. Health delivery system factors had a significant impact on three of four client-centered outcome measures. Older adults enrolled in Medicare FFS systems reported poorer general health, HADL, and AADL outcomes than Medicare HMO enrollees. Additional factors impacting general health included education, marital status, income, private insurance, census region of residence, chronic illnesses, outpatient and hospital utilization. Additional factors impacting functional status included age, education, gender, Medicaid and private insurance, census region of residence, chronic illnesses and hospital stays. Information from this study can be used to monitor outcomes of health care in this vulnerable population, inform development of chronic illness-related health policy and encourage use of high quality public data resources available for health services research.
Learning Objectives: N/A
Keywords: Outcomes Research, Health Care Managed Care
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.