Background
Methods
Study population
Data collection
Outcomes of interest
Outcome variablea
| Category | Survey question (s) |
---|---|---|
Global ratings (satisfaction) | Personal doctor | Using any number from 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor possible, what number would you use to rate your personal doctor? |
Specialist | We want to know your rating of the specialist you saw most often in the last 6 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate the specialist? | |
Health care | Using any number from 0 to 10, where 0 is the worst health care possible and 10 is the best health care possible, what number would you use to rate all of your health care in the last 6 months? | |
Supplement plan | Using any number from 0 to 10, where 0 is the worst Medicare supplement insurance plan possible and 10 is the best health plan possible, what number would you use to rate the AARP Medicare Supplement Insurance Plan? | |
Composite ratings (experiences with care) | Doctor communication | In the last 6 months, how often did your personal doctor explain things in a way that was easy to understand? |
In the last 6 months, how often did your personal doctor listen carefully to you? | ||
In the last 6 months, how often did your personal doctor show respect for what you had to say? | ||
In the last 6 months, how often did your personal doctor spend enough time with you? | ||
Chronic condition management | In the last 6 months, did your personal doctor give you clear instructions about how to manage your health condition? | |
In the last 6 months, did your personal doctor work with you to set personal goals for managing your health condition? | ||
Care coordination | In the last 6 months, how often did your personal doctor seem informed and up to date about the care you got? | |
In the last 6 month, when your personal doctor sent you for tests, how often did someone from the doctor’s office follow-up to give you test results? | ||
Access to care | In the last 6 months, when you needed care right away, how often did you get care as soon as you thought you needed? | |
In the last 6 months, not counting the times you needed care right away, how often did you get an appointment for your health care at a doctor’s office as soon as you thought you needed it? | ||
In the last 6 months, how often was it easy to get the care, tests or treatment you thought you needed? | ||
In the last 6 months, how often was it easy to get appointments with specialists? |
Covariates
Statistical analysis
Ethical considerations
Results
Sample characteristics
Before adjusting for survey non-response | |||||
---|---|---|---|---|---|
Total population | Underweight | Normal weight | Overweight | Obese | |
Participants (%)
a
| 100% | 2.8% | 38.6% | 37.2% | 21.4% |
Participants (n) | 18,192 | 516 | 7,018 | 6,765 | 3,893 |
Mean age
| 77.2 | 80.8 | 78.7 | 76.8 | 74.9 |
Gender
| |||||
Male | 39.4% | 21.1% | 32.9% | 47.9% | 38.8% |
Female | 60.6% | 78.9% | 67.1% | 52.1% | 61.2% |
Age
| |||||
65 - 69 | 18.9% | 10.5% | 15.2% | 19.1% | 26.5% |
70 - 74 | 24.3% | 17.6% | 21.1% | 25.4% | 29.0% |
75 - 79 | 18.1% | 12.8% | 17.1% | 19.0% | 19.1% |
80 - 84 | 18.3% | 25.2% | 19.3% | 18.5% | 15.3% |
85 plus | 20.3% | 33.9% | 27.2% | 18.0% | 10.2% |
Income
b
| |||||
High | 46.3% | 42.6% | 47.0% | 47.1% | 44.0% |
Upper medium | 23.5% | 23.5% | 23.5% | 23.3% | 23.7% |
Lower medium | 16.2% | 19.4% | 15.8% | 15.9% | 17.0% |
Low or missing | 14.1% | 14.5% | 13.8% | 13.7% | 15.3% |
Race
| |||||
White | 90.8% | 85.5% | 90.2% | 91.5% | 91.3% |
African American | 4.4% | 4.8% | 3.5% | 4.5% | 5.7% |
Other | 4.1% | 9.1% | 5.5% | 3.3% | 2.3% |
Education attainment
| |||||
High school graduate or less | 41.2% | 47.5% | 39.5% | 40.8% | 44.4% |
Some college or 2-year degree | 27.7% | 25.2% | 26.8% | 27.3% | 30.1% |
4 or more year college | 30.2% | 26.6% | 32.7% | 31.1% | 24.8% |
Living arrangement
| |||||
Personal home or apartment | 92.1% | 85.9% | 91.1% | 93.1% | 93.0% |
Other (Long term care, assisted living facility or Other) | 5.1% | 10.3% | 5.8% | 4.4% | 4.3% |
Need someone’s help to complete this survey
| |||||
Yes | 9.8% | 15.5% | 10.7% | 8.7% | 9.4% |
No | 88.2% | 82.2% | 87.2% | 89.3% | 88.9% |
Comorbidities
| |||||
High blood pressure | 50.0% | 38.8% | 42.1% | 52.0% | 62.5% |
Arthritis of a joint | 18.9% | 14.5% | 15.3% | 18.2% | 27.1% |
Diabetes | 13.6% | 5.8% | 7.9% | 13.5% | 25.1% |
Low back pain | 11.3% | 9.9% | 10.2% | 10.2% | 15.4% |
Other heart conditions such as heart valves or rhythm | 11.0% | 13.6% | 11.0% | 10.8% | 11.3% |
Osteoporosis | 10.6% | 16.1% | 13.8% | 8.5% | 7.7% |
Respiratory diseasec
| 10.4% | 14.0% | 9.8% | 9.2% | 13.3% |
Depression | 7.0% | 6.8% | 6.2% | 6.5% | 9.5% |
Chest pain or coronary artery disease | 6.8% | 6.0% | 5.5% | 7.3% | 8.3% |
Digestive or bowel problemsd
| 6.4% | 8.5% | 7.1% | 5.6% | 6.3% |
Any cancer | 5.5% | 6.6% | 5.2% | 5.6% | 5.7% |
Weak heart or congestive heart failure | 4.1% | 5.8% | 3.8% | 3.5% | 5.4% |
Stroke | 2.0% | 2.1% | 1.8% | 2.1% | 2.2% |
Heart attack | 1.7% | 1.0% | 1.4% | 1.7% | 2.1% |
General physical health
| |||||
Excellent or very good | 40.9% | 32.6% | 45.9% | 42.9% | 29.5% |
Good | 37.2% | 34.3% | 33.9% | 38.2% | 42.0% |
Fair or poor | 18.3% | 28.5% | 16.7% | 15.3% | 24.9% |
General mental health
| |||||
Excellent, very good or good | 89.6% | 83.1% | 88.9% | 91.0% | 89.4% |
Fair or poor | 7.3% | 12.4% | 8.0% | 5.9% | 7.6% |
Activities of daily living
| |||||
0 - 1 | 72.5% | 65.1% | 76.0% | 75.5% | 62.2% |
2 - 3 | 13.8% | 14.9% | 10.7% | 12.6% | 21.3% |
4 - 5 | 4.8% | 6.0% | 4.4% | 4.0% | 6.9% |
6 | 4.0% | 6.8% | 4.0% | 3.5% | 4.6% |
Activities of daily living (Summary Score) | 10.8 | 10.4 | 10.9 | 10.9 | 10.5 |
Satisfaction and experiences with care
BMI category | Odds ratio estimatea
| Lower C.I. | Upper C.I. | p-value | |
---|---|---|---|---|---|
Global ratings (Satisfaction)
| |||||
Global satisfaction rating for personal doctor | Underweight | 0.84 | 0.73 | 0.96 | 0.01 |
Overweight | 1.03 | 0.98 | 1.09 | 0.23 | |
Obese | 1.22 | 1.13 | 1.31 | <0.0001 | |
Global satisfaction rating for specialist (9 or higher out of 10) | Underweight | 0.98 | 0.83 | 1.16 | 0.81 |
Overweight | 1.02 | 0.96 | 1.08 | 0.61 | |
Obese | 1.13 | 1.04 | 1.23 | <0.01 | |
Global satisfaction rating for all health care (9 or higher out of 10) | Underweight | 1.03 | 0.91 | 1.16 | 0.66 |
Overweight | 1.06 | 1.01 | 1.11 | 0.01 | |
Obesity | 1.19 | 1.12 | 1.27 | <0.0001 | |
Global satisfaction rating for AARP supplement insurance (9 or higher out of 10) | Underweight | 0.98 | 0.86 | 1.11 | 0.74 |
Overweight | 1.01 | 0.96 | 1.05 | 0.76 | |
Obese | 1.09 | 1.02 | 1.16 | 0.01 | |
Composite ratings (Experiences with care)
| |||||
Personal doctor communication: Personal doctor explained things in a way that was easy to understand, listen carefully to you, show respect for what you had to say, and spend enough time with you | Underweight | 0.88 | 0.77 | 1.01 | 0.07 |
Overweight | 1.06 | 1.01 | 1.11 | 0.03 | |
Obese | 1.21 | 1.13 | 1.29 | <0.0001 | |
Chronic condition management: Personal doctor gave clear instructions about how to manage your health condition, and work with you to set personal goals for managing your health condition | Underweight | 0.93 | 0.80 | 1.07 | 0.29 |
Overweight | 0.89 | 0.85 | 0.94 | <0.0001 | |
Obese | 0.97 | 0.91 | 1.04 | 0.41 | |
Composite patient experience scores for care coordination is 90 or higher out of 100 | Underweight | 0.95 | 0.83 | 1.09 | 0.44 |
Overweight | 1.08 | 1.03 | 1.14 | 0.001 | |
Obese | 1.2 | 1.12 | 1.28 | <0.0001 | |
Composite patient experience scores for access to the care is 90 or higher out of 100 | Underweight | 0.9 | 0.79 | 1.03 | 0.13 |
Overweight | 1.04 | 0.99 | 1.09 | 0.11 | |
Obese | 1.12 | 1.06 | 1.20 | <0.001 |
Questions relating to attentiveness to care
Underweight | Normal weighta
| Overweight | Obese | |
---|---|---|---|---|
In the last 6 months, did your personal doctor or any other provider ask you to do the following to help manage this health condition
| ||||
Check your weight regularly
| 14.0% | 14.0% | 20.3%** | 30.6%** |
Check your blood sugar regularly
| 9.3%* | 11.7% | 17.2%** | 28.1%** |
Exercise or do specific physical activities
| 27.5%** | 34.5% | 41.7%** | 49.0%** |
Check your blood pressure regularly | 31.0% | 31.2% | 36.9%** | 41.1%** |
Avoid particular foods | 14.9%* | 19.3% | 23.6%** | 29.1%** |
Eat particular foods | 11.1%* | 14.9% | 16.5%** | 21.2%** |
Go to a particular group or class | 2.3% | 2.4% | 2.5% | 3.9%** |
Read a booklet or watch a video about this condition | 2.1% | 2.2% | 2.4% | 2.8%* |
Take prescription medicine | 64.5% | 63.9% | 67.6%** | 74.1%** |
In the last 6 months, how many times did you visit your personal doctor to get care for yourself?
| ||||
None | 14.3% | 14.5% | 12.1%** | 9.9%** |
1 | 27.7%* | 31.3% | 30.6% | 27.2%** |
2 | 24.8% | 23.7% | 26.6%** | 28.2%** |
3 or more | 23.1% | 23.4% | 24.9%* | 29.6%** |