Constrained Innovation in Managing Care for High-Risk Seniors in Medicare + Choice Risk Plans. B. Impairments

01/01/2002

Physical and mental impairments can make it difficult for seniors to communicate effectively with their providers, travel to and from medical appointments, and cope with major life changes. Organizations that want to serve high-risk seniors must take steps to address the complications these impairments introduce into the process of delivering care.

TABLE III.2. Factors Complicating Care for Seniors Reporting 3-12 Chronic Conditions
(Percentages and Their Standard Errors)
  Characteristics of High-Risk Seniors with 3-12 Chronic Conditionsa
0 ADL
  Limitationsb  
1-2 ADL
  Limitationsb  
3-5 ADL
  Limitationsb  
Advanced Age
(>=85)
59.2 (2.4) 69.4 (3.7) 64.0 (5.3)
Low Education
(No High School)
40.8 (3.2) 54.0 (5.2) 55.6 (6.5)
Low Income
(<$10,000)
25.3 (3.3) 41.1 (5.6) 45.7 (7.0)
All of the Above 5.8 (1.7) 17.3 (3.9) 16.7 (6.0)
None of the Above 25.4 (1.4) 16.0 (2.1) 15.6 (2.7)
Number of Observations   460 188 129
SOURCE: Sample of 777 community residents with 3 to 12 chronic conditions taken from a telephone survey of 1,657 high-risk seniors from three managed care organizations, conducted between March and December 1999 by MPR.
NOTE: Values are percentages and are weighted to represent the population and correct for nonresponse. Standard errors are in parentheses.
  1. People were asked whether they had been diagnosed with any of the following 12 chronic conditions: arteriosclerosis, hypertension, heart attack, other heart disease, previous stroke, depression, cancer, diabetes, arthritis, asthma, previous hip fracture, and Alzheimer’s or other dementia.
  2. Limitations in activities of daily living involve the need for help or supervision with the following: bathing, eating, dressing, transferring, and toileting.

 

TABLE III.3. Attitudinal Factors Affecting Care for Seniors with Multiple Chronic Conditions
(Percentages and Their Standard Errors)
  Characteristics of High-Risk Seniors With 3-12 Chronic Conditionsa in Addition to:
0 ADL
  Limitationsb  
1-2 ADL
  Limitationsb  
3-5 ADL
  Limitationsb  
Worries About Health 20.3 (2.6) 21.1 (4.0) 38.4 (8.7)
Would Do Anything to Avoid Doctor   22.1 (2.7) 28.8 (5.1) 15.7 (5.9)
When Sick, I Keep to Myself 33.2 (3.0) 34.4 (5.3) 29.5 (7.1)
Number of Observations 437 161 77
SOURCE: Sample of 675 community residents with 3 to 12 chronic conditions taken from telephone survey of 1,657 high-risk seniors from three managed care organizations, conducted between March and December 1999 by MPR. Number of observations differs from those in Table III.2, because respondents defined as representative proxies were excluded for these questions.
NOTE: Values are percentages and are weighted to represent the population and correct for nonresponse. Standard errors are in parentheses.
  1. People were asked whether they had been diagnosed with any of the following 12 chronic conditions: arteriosclerosis, hypertension, heart attack, other heart disease, previous stroke, depression, cancer, diabetes, arthritis, asthma, previous hip fracture, and Alzheimer’s or other dementia.
  2. Limitations in activities of daily living involve the need for help or supervision with the following: bathing, eating, dressing, transferring, and toileting.

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