Special Article on Dually EligibleResearch PaperUsing population-based data to examine preventive services by disability type among dually eligible (Medicare/Medicaid) adults
Section snippets
Methods
Non-institutionalized adults age 18+ were identified in the MEPS from pooled alternate years 2000–2008. In order to be identified as a dual eligible, Medicare and Medicaid eligibility had to be concurrent during the year in which they were surveyed, leading to an unweighted 5-year sample of 3514 (weighted 5-year sample = 4,428,630). Pooling data across years allowed us to achieve a sufficient sample size for the disability subgroups among those who are dually eligible for Medicaid and Medicare.
Results
Overall in our weighted sample, 49.5% of the people identified as dual eligibles either had only a cognitive limitation (4.4%), only a physical disability (32.3%) or both (“double diagnosis,” 12.8%), leaving 51.5% either without a disability or with a disability that did not fit into one or the other of these two categories. Medicare identifies disability only for people who are under 65, an estimated 41% of all dual eligibles.41 Our data suggest that there are a substantial number of dual
Discussion
The dual eligible population has become the focus of much state and federal policy recently as our understanding of their impact on our health care system has improved.11, 40, 41, 43, 44, 45, 46 Our study builds upon earlier work which explored disability prevalence within the dual eligible population, extending analyses to associations within and between categories of disabilities. We paid particular attention toward understanding factors influencing receipt of preventive services while also
Acknowledgment
The authors gratefully acknowledge statistical support was provided by Ms. Kandace Fleming and the extensive editorial support provided by Ms. Mallory Murphy of the University of Kansas in the development of this manuscript.
References (54)
- et al.
The Kansas Medicaid Buy-In: factors influencing enrollment and health care utilization
Disabil Health J
(2010) - et al.
Removing service barriers for women with physical disabilities: promoting accessibility in the gynecologic care setting
J Midwifery Womens Health
(2002) - et al.
Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States
Disabil Health J
(2011) - et al.
Analysis of seasonal influenza vaccine uptake among children and adolescents with an intellectual disability
Res Dev Disabil
(2012) - et al.
Health care expenditures of living with a disability: total expenditures, out-of-pocket expenses, and burden, 1996 to 2004
Arch Phys Med Rehabil
(2009) - et al.
Health of community-dwelling adults with mobility limitations in the United States: incidence of secondary health conditions. Part II
Arch Phys Med Rehabil
(2008) - et al.
Disability and receipt of clinical preventive services among women
Womens Health Issues
(2006) - et al.
Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2007
(December 2010) - et al.
Potentially Preventable Hospitalizations among Medicare-Medicaid Dual Eligibles, 2008
(September 2010) - et al.
Impact of health care reform on Medicare and dual Medicare-Medicaid beneficiaries
Cancer J
(2010)
Improving health care delivery to aging adults with disabilities: social work with dual eligibles in a climate of health care reform
J Gerontol Soc Work
Supporting Alternative Integrated Models for Dual Eligibles: A Legal Analysis of Current and Future Options
High-cost users among dual eligibles in three care settings
J Health Care Poor Underserved
Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis
BMC Public Health
Profile of persons with disabilities in Medicare and Medicaid
Health Care Financ Rev
Improving care for dual eligibles through innovations in financing
New Engl J Med
Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries
Improving health-based payment for Medicaid beneficiaries: CDPS
Health Care Financ Rev
Estimates of state-level health-care expenditures associated with disability
Public Health Rep
Care Coordination for dually eligible Medicare-Medicaid beneficiaries under the affordable care act
J Aging Soc Policy
Adults with dual eligibility for Medicaid and Medicare: access to substance abuse treatment
J Soc Work Disabil Rehabil
Guide to Clinical Preventive Services, 2007
Mobility impairments and use of screening and preventive services
Am J Public Health
Use of screening and preventative services among women with disabilities
Am J Med Qual
More than Ramps: A Guide to Improving Health Care Quality and Access for People with Disabilities
Cited by (0)
We have no conflicts of interest to report. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
This work was funded, in part under two Research and Training Center grants from the National Institute on Disability and Rehabilitation Research, award numbers H133B060018 and H133B110006.
We presented the content at an oral presentation at Academy Health Disability Research Interest Group meeting, Orlando, FL, June 23, 2012.
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