Quality of Services and Information

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 5.3 Implications and Recommendations

Efforts are needed to address persistent disparities in care based on race/ethnicity, socioeconomic status and gender, and for subgroups at particular risk.

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 5.2 Key Findings on Disparities in Care for Older Adults

To fill the gap in the literature about consistent disparities in quality of care for midlife vs. older adults, we conducted new analyses, taking advantage of a large, nationally representative sample of Americans evaluated in the MEPS. Analyses showed that racial/ethnic differences were prominent for effectiveness measures, with results favoring

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 5.1 Challenges in Assessing Disparities in Quality of Care for Older Adults

A major task of this report—categorization of select measures of diabetes quality of care, along with certain cardiovascular and depression care measures—revealed some important themes in limitations of existing research on disparities, particularly in care for older adults. First, most health care measures for priority conditions in older adu

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 5.0 Summary and Recommendations

This report developed a conceptual model for assessing quality of care disparities among midlife and older adults; summarized key literature findings on quality of care for diabetes, cardiovascular conditions and depression; and conducted quantitative analyses to address disparities in care among midlife and older adults with diabetes and cardiova

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 4.4 Discussion

The analysis sought to describe the relationship between health insurance coverage and the quality of care that men and women experience. The most significant, consistent findings were related to access to care. For the most part, women were significantly more likely than men to report delays in care. Differences were exhibited among midlife adult

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 4.3 Results

Table 11 shows the distribution of the key independent variables of interest among the study population. To facilitate the multivariate analyses, only persons with complete data on all analytic variables were included in the study sample (hence, the sample for this analysis differs from the previous analysis reported in Chapter 3.0, which did not

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 4.2 Methods

Nationally representative MEPS data were used to examine the relationship of age, gender and insurance status to quality of care among Americans with diabetes and cardiovascular conditions. Persons with missing education or insurance status data were excluded from the analysis (6 percent each for the diabetes and cardiovascular condition populatio

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 4.1 Background

Collectively, diabetes and cardiovascular disease account for nearly 30 percent of all deaths in the U.S. and an estimated $623 billion in direct and indirect medical costs (AHRQ 2008; CDC 2009). These diseases are among the most prevalent chronic conditions in midlife and older adult populations 45 and older. Their impact on overall health and di

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 4.0 Association of Delays, Effectiveness and Patient-Centeredness in Health Care With Age, Gender and Insurance Status Among Americans With Diabetes and Cardiovascular Conditions

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 3.4 Discussion

Although analysis results did not exhibit consistent patterns, several findings are worth noting. The most consistent finding was related to access to care. Women more often reported experiencing one or more delays in care compared to men, and delays were significantly more common among the 45–64 age groups than in the ≥65 age group. These fin

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 3.3 Results

Sociodemographic Characteristics of Midlife and Older Adults With Diabetes and Cardiovascular Conditions

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 3.2 Methods

Data

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 3.1 Background

Although disparities in the use of health services by race and income have diminished since Medicare's implementation, recent studies suggest that marked health care disparities persist among Medicare beneficiaries. Racial/ethnic minority beneficiaries fare worse than their White counter-parts on numerous measures of health status and care. For ex

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 3.0 Disparities in Diabetes and Cardiovascular Quality of Care: An Evaluation of Adults Ages 45–64 vs. the 65 and Older Population

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). Summary

This targeted review of the literature offers several key conclusions:

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 2.6 Interventions to Reduce Disparities in Diabetes and Other Priority Conditions (Cardiovascular Disease and Depression)

Despite the overarching goal of Healthy People 2010—to reduce or eliminate disparities by 2010 (U.S. Department of Health and Human Services 2000a)—most disparity studies do not explicitly address the reasons for disparities in health care. There are suggestions that the provision of lower quality of care could be an important influence in dis

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 2.5 Disparities in Other Priority Conditions: Examples From Cardiovascular Care and Depression

The paucity of diabetes literature examining quality of care disparities based on individual factors other than race/ethnicity, and which also differentiate between midlife and older adults who have different health insurance coverage situations that could affect care, is similar for other priority conditions. This section briefly highlights the l

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 2.4 Disparities in Diabetes Quality of Care

Defining a Health Care Quality Measure Although many measures are available to assess quality of care, this report focuses on clinical performance measures. Previous authors have defined clinical performance measures as

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 2.3 Disparities in Diabetes Complications

Diabetes can lead to serious complications, including blindness, cardiovascular disease, kidney damage and lower-limb amputations, although proper management and quality care can reduce the risk of complications (CDC 2007a). The majority of disparities literature on diabetes complications focuses on race and ethnicity differences and pays less att

Disparities in Quality of Care for Midlife Adults (Ages 45–64) Versus Older Adults (Ages >65). 2.2 Disparities in Diabetes Prevalence Rates

Diabetes, a priority condition in the U.S., is a group of diseases characterized by high blood glucose levels, resulting from defects in insulin secretion or action (Centers for Disease Control and Prevention [CDC] 2007a). It is the sixth leading cause of death in the U.S., and incurs annual medical costs of over $100 billion (Agency for Healthcar

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