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The impact of marital status on health care utilization among Medicare beneficiaries

To explain prior literature showing that married Medicare beneficiaries achieve better health outcomes at half the per person cost of single beneficiaries, we examined different patterns of healthcare utilization as a potential driver. Using the Medicare Current Beneficiary Survey (MCBS) data, we so...

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Autores principales: Pandey, Kiran Raj, Yang, Fan, Cagney, Kathleen A., Smieliauskas, Fabrice, Meltzer, David O., Ruhnke, Gregory W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709281/
https://www.ncbi.nlm.nih.gov/pubmed/30896632
http://dx.doi.org/10.1097/MD.0000000000014871
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author Pandey, Kiran Raj
Yang, Fan
Cagney, Kathleen A.
Smieliauskas, Fabrice
Meltzer, David O.
Ruhnke, Gregory W.
author_facet Pandey, Kiran Raj
Yang, Fan
Cagney, Kathleen A.
Smieliauskas, Fabrice
Meltzer, David O.
Ruhnke, Gregory W.
author_sort Pandey, Kiran Raj
collection PubMed
description To explain prior literature showing that married Medicare beneficiaries achieve better health outcomes at half the per person cost of single beneficiaries, we examined different patterns of healthcare utilization as a potential driver. Using the Medicare Current Beneficiary Survey (MCBS) data, we sought to understand utilization patterns in married versus currently-not-married Medicare beneficiaries. We analyzed the relationship between marital status and healthcare utilization (classified based on setting of care utilization into outpatient, inpatient, and skilled nursing facility (SNF) use) using logistic regression modeling. We specified models to control for possible confounders based on the Andersen model of healthcare utilization. Based on 13,942 respondents in the MCBS dataset, 12,929 had complete data, thus forming the analytic sample, of whom 6473 (50.3%) were married. Of these, 58% (vs. 36% of those currently-not-married) were male, 45% (vs. 47%) were age >75, 24% (vs. 70%) had a household income below $25,000, 18% (vs. 14%) had excellent self-reported general health, and 56% (vs. 36%) had private insurance. Compared to unmarried respondents, married respondents had a trend toward higher odds of having a recent outpatient visit (unadjusted odds ratio (OR) 1.11, 95% confidence interval (CI) 1.04–1.19, adjusted odds ratio (AOR) 1.10, (CI) 0.99–1.22), and lower odds in the year prior to have had an inpatient stay (AOR 0.84, CI 0.72–0.99) or a SNF stay (AOR 0.55, CI 0.40–0.75). Based on MCBS data, odds of self-reported inpatient and SNF use were lower among married respondents, while unadjusted odds of outpatient use were higher, compared to currently-not-married beneficiaries.
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spelling pubmed-67092812019-10-01 The impact of marital status on health care utilization among Medicare beneficiaries Pandey, Kiran Raj Yang, Fan Cagney, Kathleen A. Smieliauskas, Fabrice Meltzer, David O. Ruhnke, Gregory W. Medicine (Baltimore) Research Article To explain prior literature showing that married Medicare beneficiaries achieve better health outcomes at half the per person cost of single beneficiaries, we examined different patterns of healthcare utilization as a potential driver. Using the Medicare Current Beneficiary Survey (MCBS) data, we sought to understand utilization patterns in married versus currently-not-married Medicare beneficiaries. We analyzed the relationship between marital status and healthcare utilization (classified based on setting of care utilization into outpatient, inpatient, and skilled nursing facility (SNF) use) using logistic regression modeling. We specified models to control for possible confounders based on the Andersen model of healthcare utilization. Based on 13,942 respondents in the MCBS dataset, 12,929 had complete data, thus forming the analytic sample, of whom 6473 (50.3%) were married. Of these, 58% (vs. 36% of those currently-not-married) were male, 45% (vs. 47%) were age >75, 24% (vs. 70%) had a household income below $25,000, 18% (vs. 14%) had excellent self-reported general health, and 56% (vs. 36%) had private insurance. Compared to unmarried respondents, married respondents had a trend toward higher odds of having a recent outpatient visit (unadjusted odds ratio (OR) 1.11, 95% confidence interval (CI) 1.04–1.19, adjusted odds ratio (AOR) 1.10, (CI) 0.99–1.22), and lower odds in the year prior to have had an inpatient stay (AOR 0.84, CI 0.72–0.99) or a SNF stay (AOR 0.55, CI 0.40–0.75). Based on MCBS data, odds of self-reported inpatient and SNF use were lower among married respondents, while unadjusted odds of outpatient use were higher, compared to currently-not-married beneficiaries. Wolters Kluwer Health 2019-03-22 /pmc/articles/PMC6709281/ /pubmed/30896632 http://dx.doi.org/10.1097/MD.0000000000014871 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Pandey, Kiran Raj
Yang, Fan
Cagney, Kathleen A.
Smieliauskas, Fabrice
Meltzer, David O.
Ruhnke, Gregory W.
The impact of marital status on health care utilization among Medicare beneficiaries
title The impact of marital status on health care utilization among Medicare beneficiaries
title_full The impact of marital status on health care utilization among Medicare beneficiaries
title_fullStr The impact of marital status on health care utilization among Medicare beneficiaries
title_full_unstemmed The impact of marital status on health care utilization among Medicare beneficiaries
title_short The impact of marital status on health care utilization among Medicare beneficiaries
title_sort impact of marital status on health care utilization among medicare beneficiaries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709281/
https://www.ncbi.nlm.nih.gov/pubmed/30896632
http://dx.doi.org/10.1097/MD.0000000000014871
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