دورية أكاديمية
Health Care Contact Days Among Older Adults in Traditional Medicare : A Cross-Sectional Study.
| العنوان: | Health Care Contact Days Among Older Adults in Traditional Medicare : A Cross-Sectional Study. |
|---|---|
| المؤلفون: | Ganguli I; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston; and Harvard University, Boston, Massachusetts (I.G., E.J.O.)., Chant ED; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts (E.D.C.)., Orav EJ; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston; and Harvard University, Boston, Massachusetts (I.G., E.J.O.)., Mehrotra A; Harvard University, Boston; and Beth Israel Deaconess Medical Center, Boston, Massachusetts (A.M.)., Ritchie CS; Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston; and Harvard University, Boston, Massachusetts (C.S.R.). |
| المصدر: | Annals of internal medicine [Ann Intern Med] 2024 Feb; Vol. 177 (2), pp. 125-133. Date of Electronic Publication: 2024 Jan 23. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: American College of Physicians--American Society of Internal Medicine Country of Publication: United States NLM ID: 0372351 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1539-3704 (Electronic) Linking ISSN: 00034819 NLM ISO Abbreviation: Ann Intern Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2001->: Philadelphia, PA : American College of Physicians--American Society of Internal Medicine Original Publication: Philadelphia [etc.] American College of Physicians. |
| مواضيع طبية MeSH: | Medicare* , Patient Acceptance of Health Care*, Humans ; Aged ; Female ; United States ; Cross-Sectional Studies ; Hospitals ; Chronic Disease |
| مستخلص: | Background: Days spent obtaining health care outside the home can represent not only access to needed care but also substantial time, effort, and cost, especially for older adults and their care partners. Yet, these "health care contact days" have not been characterized. Objective: To assess composition of, variation and patterns in, and factors associated with contact days among older adults. Design: Cross-sectional study. Setting: Nationally representative 2019 Medicare Current Beneficiary Survey data linked to claims. Participants: Community-dwelling adults aged 65 years and older in traditional Medicare. Measurements: Ambulatory contact days (days with a primary care or specialty care office visit, test, imaging, procedure, or treatment) and total contact days (ambulatory days plus institutional days in a hospital, emergency department, skilled-nursing facility, or hospice facility); multivariable mixed-effects Poisson regression to identify patient factors associated with contact days. Results: In weighted results, 6619 older adults (weighted: 29 694 084) had means of 17.3 ambulatory contact days (SD, 22.1) and 20.7 total contact days (SD, 27.5) in the year; 11.1% had 50 or more total contact days. Older adults spent most contact days on ambulatory care, including primary care visits (mean [SD], 3.5 [5.0]), specialty care visits (5.7 [9.6]), tests (5.3 [7.2]), imaging (2.6 [3.9]), procedures (2.5 [6.4]), and treatments (5.7 [13.3]). Half of the test and imaging days were not on the same days as office visits (48.6% and 50.1%, respectively). Factors associated with more ambulatory contact days included younger age, female sex, White race, non-Hispanic ethnicity, higher income, higher educational attainment, urban residence, more chronic conditions, and care-seeking behaviors (for example, "go to the doctor…as soon as (I)…feel bad"). Limitation: Study population limited to those in traditional Medicare. Conclusion: On average, older adults spent 3 weeks in the year getting care outside the home. These contact days were mostly ambulatory and varied widely not only by number of chronic conditions but also by sociodemographic factors, geography, and care-seeking behaviors. These results show factors beyond clinical need that may drive overuse and underuse of contact days and opportunities to optimize this person-centered measure to reduce patient burdens, for example, via care coordination. Primary Funding Source: National Institute on Aging. Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-2331. |
| التعليقات: | Comment in: Ann Intern Med. 2024 Feb;177(2):249-250. doi: 10.7326/M23-3453. (PMID: 38252941) |
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| معلومات مُعتمدة: | K23 AG068240 United States AG NIA NIH HHS |
| تواريخ الأحداث: | Date Created: 20240122 Date Completed: 20240221 Latest Revision: 20240802 |
| رمز التحديث: | 20240802 |
| مُعرف محوري في PubMed: | PMC10923005 |
| DOI: | 10.7326/M23-2331 |
| PMID: | 38252944 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1539-3704 |
|---|---|
| DOI: | 10.7326/M23-2331 |