Dataset Information

Outcomes in Older Adults with Multimorbidity Associated with Predominant Provider of Care Specialty.

ABSTRACT:

Objectives

To determine whether receiving the predominance of ambulatory visits from a primary care provider compared to a specialty provider is associated with better outcomes in older adults with multi morbidity.

Design

Observational study using propensity score matching.

Setting

Medicare fee-for-service, 2011-12.

Participants

Beneficiaries aged 65 and older with multimorbidity.

Measurements

The independent variable was an indicator for having a specialty (versus primary care) as the predominant provider of care (PPC). Main outcomes were 1-year mortality, hospitalization, standardized expenditures, and ambulatory visit patterns.

Results

Two-thirds of 3,934,942 beneficiaries with multimorbidity had a primary care provider as their PPC. Individuals with a specialty PPC had more hospitalizations (40.3 more per 1,000) and higher spending ($1,781 more per beneficiary) than those with a primary care PPC, but there was little difference in mortality (0.2% higher) or preventable hospitalizations. Spending differences were largest for professional fees ($769 higher per beneficiary), inpatient stays ($572 higher per beneficiary), and outpatient facilities ($510 higher per beneficiary) (all P < .001). In addition, people with a specialist PPC had lower continuity of care and saw more providers.

Conclusions

Older adults with multimorbidity with a specialist as their main ambulatory care provider had higher spending and lower continuity of care than those whose PPC was in primary care but similar clinical outcomes.

SUBMITTER: Bynum JPW

PROVIDER: S-EPMC5603352 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Outcomes in Older Adults with Multimorbidity Associated with Predominant Provider of Care Specialty.

Bynum Julie P W JPW Chang Chiang-Hua CH Austin Andrea A Carmichael Don D Meara Ellen E

Journal of the American Geriatrics Society 20170408 9

<h4>Objectives</h4>To determine whether receiving the predominance of ambulatory visits from a primary care provider compared to a specialty provider is associated with better outcomes in older adults with multi morbidity.<h4>Design</h4>Observational study using propensity score matching.<h4>Setting</h4>Medicare fee-for-service, 2011-12.<h4>Participants</h4>Beneficiaries aged 65 and older with multimorbidity.<h4>Measurements</h4>The independent variable was an indicator for having a specialty (v ...[more]

PMID: 28390184

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Dataset Information

Outcomes in Older Adults with Multimorbidity Associated with Predominant Provider of Care Specialty.

Objectives

Design

Setting

Participants

Measurements

Results

Conclusions

Publications

Outcomes in Older Adults with Multimorbidity Associated with Predominant Provider of Care Specialty.

Similar Datasets

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