Table 3.

Association between Gender, Managed Care, and Problematic Health Care Experiences

	Prevalence of Problems				Types of Problems
Respondent Characteristics	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Female	1.2	[1.04 1.39]**	1.2	[1.09 1.42]***	1.3	[1.10 1.52]***	1.2	[1.04 1.41]**	1.1	[0.94 1.36]
Health plan managed care practices
Closed network of providers	1.2	[1.04 1.44]**	1.3	[1.19 1.58]***	1.3	[1.15 1.65]***	1.3	[1.13 1.57]***	0.9	[0.80 1.21]
Require selection of primary provider	0.7	[0.64 0.88]***	0.8	[0.77 1.03]	1.0	[0.85 1.21]	0.7	[0.61 0.85]***	1.3	[1.10 1.68]**
Gatekeeper requirements for referrals	1.3	[1.18 1.62]***	1.3	[1.18 1.56]***	1.3	[1.16 1.64]***	1.1	[0.96 1.32]	1.7	[1.39 2.13]***
Prior approval for treatment	1.1	[0.98 1.33]	1.3	[1.20 1.58]***	1.0	[0.84 1.19]	1.5	[1.29 1.79]***	1.0	[0.85 1.28]
Managed care market characteristics
High HMO competition	0.8	[0.73 1.07]	0.9	[0.80 1.12]	0.9	[0.78 1.18]	0.7	[0.60 0.90]**	1.1	[0.91 1.47]
Medicaid HMO competition	1.0	[0.85 1.21]	1.1	[0.94 1.28]	1.1	[0.97 1.41]	0.7	[0.62 0.89]***	1.2	[1.01 1.57]*
High HMO penetration	1.5	[1.20 1.88]***	1.2	[1.05 1.56]**	1.3	[1.08 1.76]**	1.3	[1.11 1.75]**	1.6	[1.21 2.17]***
Medicaid HMO penetration	1.5	[1.25 1.85]***	1.3	[1.11 1.57]***	1.3	[1.09 1.68]**	1.7	[1.43 2.13]***	1.4	[1.10 1.87]**
Managed care regulatory policies
Direct access to OB/GYN	1.1	[0.95 1.33]	1.0	[0.94 1.27]	1.3	[1.08 1.57]**	0.9	[0.83 1.17]	1.0	[0.81 1.24]
Specialist as primary care provider	1.0	[0.89 1.20]	1.0	[0.91 1.17]	1.0	[0.91 1.25]	1.0	[0.87 1.18]	0.8	[0.74 1.08]

Odds ratios from logistic regression models weighted to the sample population. All models control for respondent demographic and socioeconomic characteristics, health status, insurance characteristics, and geographic region.

Reference group for managed care market characteristics are low HMO competition and low HMO penetration.

Significance:

^*p<.05;

^**p<.01;

^***p<.001.