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Quality of physician care and change...

Lee, Dongsoo.

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Quality of physician care and changes in health over time among elderly Medicare beneficiaries with chronic illness.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Quality of physician care and changes in health over time among elderly Medicare beneficiaries with chronic illness./
作者:	Lee, Dongsoo.
面頁冊數:	271 p.
附註:	Source: Dissertation Abstracts International, Volume: 65-05, Section: A, page: 1913.
Contained By:	Dissertation Abstracts International65-05A.
標題:	Gerontology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3133554
ISBN:	0496807935

Quality of physician care and changes in health over time among elderly Medicare beneficiaries with chronic illness.
Lee, Dongsoo.

Quality of physician care and changes in health over time among elderly Medicare beneficiaries with chronic illness. - 271 p.

Source: Dissertation Abstracts International, Volume: 65-05, Section: A, page: 1913.

Thesis (Ph.D.)--University of Massachusetts Boston, 2003.

Based on Donabedian's framework (1966) of medical care quality, this project entailed an empirical examination of the association between structure and process indicators of quality of care, as well as individual risk factors, and changes of self-rated health status and mortality over time among elderly Medicare beneficiaries with specific chronic diseases---congestive heart failure, myocardial infarction, stroke, and diabetes.

ISBN: 0496807935Subjects--Topical Terms:

533633
Gerontology.

Quality of physician care and changes in health over time among elderly Medicare beneficiaries with chronic illness.
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500 $a Source: Dissertation Abstracts International, Volume: 65-05, Section: A, page: 1913.
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520 $a Based on Donabedian's framework (1966) of medical care quality, this project entailed an empirical examination of the association between structure and process indicators of quality of care, as well as individual risk factors, and changes of self-rated health status and mortality over time among elderly Medicare beneficiaries with specific chronic diseases---congestive heart failure, myocardial infarction, stroke, and diabetes.
520 $a The main data source was the Access to Care (ATC), a component of the Medicare Current Beneficiary Survey (MOBS), from 1992 to 1996. The MCBS was a continuous panel survey of a nationally representative sample of Medicare beneficiaries. Data from multiple years (1992--1996) of the MCBS were pooled between surveys to measure annual changes in self-rated health status and mortality. The entire study sample of 32,193 beneficiary years included the study condition sample (N = 13,352) and the non-study condition sample (N = 18,841). The study condition sample was comprised of 7,060 beneficiary years for individuals with heart diseases, 4,532 with stroke, and 6,378 with diabetes.
520 $a Descriptive statistics of the baseline self-rated health status and multinomial logit regression analyses were used to examine the associations between individual factors and self-reported health status across the three study chronic conditions.
520 $a The general patterns of the study results suggest that changes in self-reported health status and mortality outcomes are largely driven by individual risk factors such as illness and health behaviors rather than process indicators and structural factors, regardless of the study conditions and the baseline health status. Among illness and health behavior factors, more functional status problems and more coexisting diseases were found to be the strongest predictors of self-rated health status decline and mortality. The process indicators and structural attributes, overall, were identified to play a moderate role in self-rated health status changes and mortality.
520 $a The findings of this study have implications that are related to management of chronic conditions. Healthcare policy should focus not only on delaying disease process, but also on preventing disease related-complications and adverse outcomes, and on helping the elderly Medicare beneficiaries to manage their own chronic illness.
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