Table 4.
Distribution of Elder Characteristics by International Medical School Graduate (IMG) Physicians versus United States Medical School Graduate (USMG) Physicians
| Elders with IMGs | Elders with USMGs | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Elders Characteristics | 1986 | 1990 | 1994 | 1998 | 1986 | 1990 | 1994 | 1998 | p-value* |
| N | 292 | 303 | 222 | 132 | 2,958 | 2,097 | 1,812 | 1,090 | .008‡ |
| White | 46.2 | 42.6 | 34.7 | 34.1 | 50.0 | 52.2 | 49.5 | 49.8 | .006 |
| African American | 53.8 | 57.4 | 65.3 | 65.9 | 50.0 | 47.8 | 50.5 | 50.2 | |
| Male | 34.6 | 34.0 | 37.8 | 40.2 | 31.7 | 29.8 | 29.9 | 29.1 | .117 |
| Age | 73.8 | 76.2 | 78.6 | 81.9 | 73.7 | 76.2 | 78.7 | 81.9 | .704 |
| Mean years of education | 8.3 | 8.1 | 8.4 | 8.3 | 8.9 | 9.0 | 9.0 | 9.3 | .002 |
| Married | 36.6 | 35.0 | 32.9 | 31.1 | 39.0 | 35.7 | 33.8 | 31.3 | .892 |
| Currently working | 8.6 | 6.3 | 8.6 | 6.8 | 11.9 | 10.2 | 7.4 | 5.7 | .011 |
| Income: | |||||||||
| $0–$3,999 | 24.3 | 15.5 | 6.3 | 6.8 | 16.9 | 10.7 | 5.4 | 2.6 | <.001 |
| $5,000–$6,999 | 29.5 | 37.3 | 35.1 | 27.3 | 28.1 | 32.0 | 29.7 | 25.0 | |
| $7,000–$14,999 | 17.8 | 23.4 | 26.1 | 31.1 | 19.0 | 22.6 | 27.2 | 27.2 | |
| ≥$15,000 | 8.9 | 11.2 | 19.4 | 18.2 | 16.8 | 21.3 | 22.0 | 25.4 | |
| Medicaid insurance | 11.0 | 14.2 | 25.7 | 36.4 | 7.3 | 13.3 | 19.9 | 24.9 | .003 |
| Medi-gap insurance | 45.5 | 47.2 | 40.1 | 34.1 | 55.4 | 56.8 | 52.3 | 50.8 | <.001 |
| Self-reported health | |||||||||
| Excellent or good | 43.2 | 46.5 | 52.3 | 42.4 | 51.0 | 51.7 | 51.9 | 48.9 | .027 |
| Fair | 34.9 | 32.3 | 30.6 | 30.3 | 30.9 | 30.4 | 28.0 | 27.6 | |
| Poor | 18.2 | 11.6 | 8.1 | 6.1 | 13.6 | 10.0 | 8.4 | 9.2 | |
| Severity of illness | |||||||||
| Good | 21.6 | 24.4 | 18.0 | 17.4 | 22.2 | 22.7 | 18.5 | 18.4 | .290 |
| Fair | 55.8 | 44.6 | 49.1 | 50.0 | 51.6 | 47.4 | 44.7 | 42.2 | |
| Poor | 22.6 | 28.4 | 31.1 | 31.1 | 25.6 | 28.5 | 35.4 | 37.4 | |
| One or more ADL limitation | 12.7 | 19.1 | 22.1 | 31.8 | 12.0 | 19.9 | 21.4 | 35.0 | .839 |
| Ever in a nursing home? | 2.4 | 5.0 | 7.7 | 15.9 | 1.9 | 4.9 | 10.4 | 15.5 | .734 |
| Lives in a rural area? | 80.8 | 81.2 | 87.4 | 97.7 | 53.9 | 54.4 | 53.1 | 53.2 | NA† |
| Lives in the same county as MD practices? | 89.7 | 81.5 | 49.5 | 65.2 | 81.4 | 80.3 | 82.4 | 78.0 | NA† |
| Received care in ER or public clinic/hospital | 7.9 | 11.2 | 16.2 | 0.0 | 15.1 | 13.3 | 15.4 | 10.3 | <.001 |
| Received care in private office/hospital§ | 92.1 | 88.8 | 83.8 | 100.0 | 84.9 | 86.4 | 84.5 | 89.5 | |
| Received consistent care | 100.0 | 93.4 | 84.2 | 78.0 | 100.0 | 91.6 | 76.2 | 73.4 | .203 |
| Received inconsistent care | 6.6 | 15.8 | 22.0 | 8.4 | 23.8 | 26.6 | .018 | ||
| Has usual source of care | 79.5 | 69.4 | 62.9 | 83.1 | 70.4 | 62.6 | .915 | ||
P-value indicates differences in physician characteristics between categories of USMG and IMG and is obtained from generalized estimating equations.
P-value indicates there is a differential effect over time (significant interaction of USMG/IMG by time) in which differences in characteristics vary across time therefore no main effects model can be presented (lives in rural area, p<.001; elder resides in same county as MD, p<.001).
P-value indicates differences in number of elders treated by IMGs and USMGs over time as obtained from generalized estimating equations.
The statistic for private office/hospital is the same as for public clinic/hospital or ER as these variables are the inverse of each other.
ADL, activities of daily living; NA, not applicable.