OBJECTIVE: To assess, using a longitudinal definition, the impact of disability on a broad range of objective health care quality indicators. DESIGN: Longitudinal cohort study following up with patients over several years. The first 2 interviews, 1 year apart, were used to determine each patient's disability status in activities of daily living (ADLs). Assessment of the health care indicators commenced after the second interview and continued throughout the survey period (an additional 1-3y). SETTING: National survey. PARTICIPANTS: Participants (N=29,074) of the Medicare Current Beneficiary Survey (1992-2001) with no, increasing, decreasing, and stable ADL disability. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The incidence of 5 avoidable outcomes, receipt of 3 preventive care measures, and adherence to 32 diagnostically based indicators assessing the quality of treatment for acute myocardial infarction [AMI], angina, breast cancer, cerebrovascular accident, transient ischemic attack, cholelithiasis, chronic obstructive pulmonary disease [COPD], congestive heart failure, depression, gastrointestinal bleeding, diabetes, and hypertension. RESULTS: For most indicators, less than 75% of eligible patients received necessary care, regardless of disability status. For 5 indicators, less than 50% of patients received appropriate treatment. In a logistic regression analysis that controlled for patient age, sex, race, and income, disability status was a significant factor in 7 quality measures (AMI, breast cancer, COPD, diabetes, angina, pneumonia, annual visits). CONCLUSIONS: Using a longitudinal definition of disability and objective health quality indicators, we found that disability status can be an important factor in determining receipt of quality health care in a broad range of diagnostic categories. However, the impact of disability status varies depending on the indicator measured. In this cohort of patients, the changing nature of a person's disability seems to have less impact than whether they ever have had any functional deficits.
OBJECTIVE: To assess, using a longitudinal definition, the impact of disability on a broad range of objective health care quality indicators. DESIGN: Longitudinal cohort study following up with patients over several years. The first 2 interviews, 1 year apart, were used to determine each patient's disability status in activities of daily living (ADLs). Assessment of the health care indicators commenced after the second interview and continued throughout the survey period (an additional 1-3y). SETTING: National survey. PARTICIPANTS: Participants (N=29,074) of the Medicare Current Beneficiary Survey (1992-2001) with no, increasing, decreasing, and stable ADL disability. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The incidence of 5 avoidable outcomes, receipt of 3 preventive care measures, and adherence to 32 diagnostically based indicators assessing the quality of treatment for acute myocardial infarction [AMI], angina, breast cancer, cerebrovascular accident, transient ischemic attack, cholelithiasis, chronic obstructive pulmonary disease [COPD], congestive heart failure, depression, gastrointestinal bleeding, diabetes, and hypertension. RESULTS: For most indicators, less than 75% of eligible patients received necessary care, regardless of disability status. For 5 indicators, less than 50% of patients received appropriate treatment. In a logistic regression analysis that controlled for patient age, sex, race, and income, disability status was a significant factor in 7 quality measures (AMI, breast cancer, COPD, diabetes, angina, pneumonia, annual visits). CONCLUSIONS: Using a longitudinal definition of disability and objective health quality indicators, we found that disability status can be an important factor in determining receipt of quality health care in a broad range of diagnostic categories. However, the impact of disability status varies depending on the indicator measured. In this cohort of patients, the changing nature of a person's disability seems to have less impact than whether they ever have had any functional deficits.
Authors: Amitabh Jha; Donald L Patrick; Richard F MacLehose; Jason N Doctor; Leighton Chan Journal: Arch Phys Med Rehabil Date: 2002-10 Impact factor: 3.966
Authors: L Chan; J N Doctor; R F MacLehose; H Lawson; R A Rosenblatt; L M Baldwin; A Jha Journal: Arch Phys Med Rehabil Date: 1999-06 Impact factor: 3.966
Authors: Leighton Chan; Shelli Beaver; Richard F Maclehose; Amitabh Jha; Matthew Maciejewski; Jason N Doctor Journal: Arch Phys Med Rehabil Date: 2002-09 Impact factor: 3.966
Authors: L Ferrucci; J M Guralnik; E Simonsick; M E Salive; C Corti; J Langlois Journal: J Gerontol A Biol Sci Med Sci Date: 1996-05 Impact factor: 6.053
Authors: Ling Na; Sean Hennessy; Hillary R Bogner; Jibby E Kurichi; Margaret Stineman; Joel E Streim; Pui L Kwong; Dawei Xie; Liliana E Pezzin Journal: Disabil Health J Date: 2016-10-04 Impact factor: 2.554
Authors: Hillary R Bogner; Heather F de Vries McClintock; Sean Hennessy; Jibby E Kurichi; Joel E Streim; Dawei Xie; Liliana E Pezzin; Pui L Kwong; Margaret G Stineman Journal: Arch Phys Med Rehabil Date: 2015-06-26 Impact factor: 3.966
Authors: Jibby E Kurichi; Liliana Pezzin; Joel E Streim; Pui L Kwong; Ling Na; Hillary R Bogner; Dawei Xie; Sean Hennessy Journal: Arch Gerontol Geriatr Date: 2017-05-18 Impact factor: 3.250
Authors: Stephen P Gulley; Elizabeth K Rasch; Christina D Bethell; Adam C Carle; Benjamin G Druss; Amy J Houtrow; Amanda Reichard; Leighton Chan Journal: Disabil Health J Date: 2018-01-10 Impact factor: 2.554