Nancy A Miller1, Adele Kirk, Brandy Alston, Lukas Glos. 1. *Address correspondence to Nancy A. Miller, Department of Public Policy, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore MD 21250. E-mail: nanmille@umbc.edu.
Abstract
PURPOSE OF THE STUDY: We extend research to examine relations between gender, disability, and age in the receipt of preventive services. DESIGN AND METHODS: We pool Medical Expenditure Panel Survey data for years 2001-2007. Using logit models, we examine the relations between gender, disability, and age and the receipt of preventive services. RESULTS: For most services, both women and men with disabilities had higher probabilities of receiving preventive services relative to those without disabilities. There was a pattern of more significant differences for men relative to women. Predicted probabilities for receipt of services were significantly higher among older adults relative to younger adults. A usual source of care was a significant predictor across services. For example, we estimate that adults aged 18-64 with a place as a usual source of care received 59% of recommended services, whereas those with a person as a source of care received 63% of services relative to 47% for those without a usual source of care. Among older adults, the predicted percentage of preventive services received for no usual source of care was 52% and that for a place or a person as a usual source of care were 71% and 76%, respectively. Across gender, disability, and age, receipt of a range of clinical preventive services is suboptimal. IMPLICATIONS: Policy actions that may mitigate the differences we observed include mechanisms to support access to a usual source of care, financial incentives to enhance the receipt of preventive services, and implementation of community-based prevention services with attention to their linkage to clinical care.
PURPOSE OF THE STUDY: We extend research to examine relations between gender, disability, and age in the receipt of preventive services. DESIGN AND METHODS: We pool Medical Expenditure Panel Survey data for years 2001-2007. Using logit models, we examine the relations between gender, disability, and age and the receipt of preventive services. RESULTS: For most services, both women and men with disabilities had higher probabilities of receiving preventive services relative to those without disabilities. There was a pattern of more significant differences for men relative to women. Predicted probabilities for receipt of services were significantly higher among older adults relative to younger adults. A usual source of care was a significant predictor across services. For example, we estimate that adults aged 18-64 with a place as a usual source of care received 59% of recommended services, whereas those with a person as a source of care received 63% of services relative to 47% for those without a usual source of care. Among older adults, the predicted percentage of preventive services received for no usual source of care was 52% and that for a place or a person as a usual source of care were 71% and 76%, respectively. Across gender, disability, and age, receipt of a range of clinical preventive services is suboptimal. IMPLICATIONS: Policy actions that may mitigate the differences we observed include mechanisms to support access to a usual source of care, financial incentives to enhance the receipt of preventive services, and implementation of community-based prevention services with attention to their linkage to clinical care.
Authors: Lama Assi; Varshini Varadaraj; Ahmed F Shakarchi; Orla C Sheehan; Nicholas S Reed; Joshua R Ehrlich; Bonnielin K Swenor Journal: JAMA Ophthalmol Date: 2020-12-01 Impact factor: 7.389
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