DOI
https://doi.org/10.25772/BNP8-A755
Defense Date
2008
Document Type
Thesis
Degree Name
Master of Public Health
Department
Epidemiology & Community Health
First Advisor
May Kennedy
Abstract
OBJECTIVE: To investigate the relationship between Medicare Managed Care (MMC) penetration and percentage of disability in older adults (individuals age 65 and older). Considering disability as an indicator of one or more unsuccessfully managed chronic diseases, this study investigates the assumption that managed care improves coordination of care, as well as access to preventive care. If managed care’s mandate is being met, then it should be evidenced in decreased prevalence of older adult disability. METHOD: Taking an ecological approach, this study used data from the Agency for Healthcare Research and Quality (AHRQ, 2003) to compare the percentage of older adult disability in counties from 30 states and the District of Columbia with high and low MMC penetration. Covariates representing various aspects of community context were introduced into a final multivariate linear regression to examine whether MMC penetration was a significant predictor of countywide percent of older adult disability. RESULTS: While MMC penetration was a significant predictor of prevalence of older adult disability in a bivariate analysis (r=-0.197, p < .001), it lost its significance in the final multivariate model. CONCLUSION: While this study does not demonstrate a relationship between MMC penetration and prevalence of older adult disability, it is possible that MMC, once fully implemented under the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, could lead to reduced prevalence of disability.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
December 2008