Table D.
Sensitivity Analysis of Regressions to Combining Marginal and Inadequate Health Literacy Categories (N = 311)
| Plan Preferences | Plan A (Medium Cost, Medium Coverage) | Plan B (Low Cost, Low Coverage) | |
|---|---|---|---|
| Characteristic | Odds Ratio [95% CI] | Relative Risk [95% CI] | |
| Health literacy | |||
| Adequate | — | — | — |
| Marginal/inadequate | 0.45* [0.23, 0.90] | 0.99 [0.37, 2.66] | 2.35 [0.67, 8.22] |
|
| |||
| Age | |||
| 60–69 years | 1.38 [0.72, 2.65] | 1.54 [0.69, 3.47] | 0.61 [0.17, 2.22] |
| 70–79-years | 0.85 [0.42, 1.70] | 1.94 [0.81, 4.69] | 1.16 [0.28, 4.79] |
| >80 years | — | — | — |
|
| |||
| Sex | |||
| Male | 0.48* [0.26, 0.86] | 1.07 [0.53, 2.16] | 1.19 [0.37, 3.84] |
|
| |||
| Race | |||
| White | — | — | — |
| Black | 0.57 [0.29, 1.12] | 1.69 [0.70, 4.08] | 2.31 [0.55, 9.75] |
| Other | 0.64 [0.33,1.24] | 1.82 [0.73, 4.55] | 2.88 [0.75, 11.10] |
|
| |||
| Education | |||
| Less than high school | 0.73 [0.35,1.51] | 1.46 [0.66, 3.25] | 1.35 [0.37, 4.96] |
| High school | 1.42 [0.56, 3.58] | 1.62 [0.51, 5.14] | 0.27 [0.05, 1.57] |
| >High school | — | — | |
|
| |||
| Income | |||
| Low income (≤$2,000) | 0.47* [0.25, 0.89] | 1.05 [0.49, 2.28] | 1.18 [0.35, 3.96] |
| High income (>$2,000) | — | — | — |
|
| |||
| Insurance | |||
| Medicare FFS | 3.85** [1.64, 9.03] | 0.81 [0.30, 2.15] | 0.33 [0.06, 1.70] |
| Medicare Advantage | — | — | — |
| Supplemental prescription | 3.48** [1.78, 6.79] | 0.77 [0.36, 1.67] | 0.16* [0.03, 0.79] |
| Supplemental (MediGap) | 3.04** [1.22, 7.57] | 0.52 [0.15, 1.80] | 0.5 [0.08, 2.92] |
|
| |||
| Health status | |||
| Excellent/very good | — | — | — |
| Good | 0.69 [0.36, 1.33] | 1.12 [0.48, 2.62] | 0.36 [0.10, 1.31] |
| Fair/poor | 0.62 [0.29, 1.29] | 1.21 [0.43, 3.39] | 1.14 [0.26, 5.05] |
|
| |||
| Chronic conditions | |||
| 0–1 | — | — | — |
| 2–3 | 0.62 [0.32, 1.21] | 0.84 [0.36, 1.94] | 1.3 [0.40, 4.19] |
| 4+ | 0.93 [0.40, 2.15] | 0.96 [0.33, 2.79] | 0.76 [0.14, 4.10] |
|
| |||
| Functional health status | |||
| Any ADL impairment | 0.94 [0.49, 1.78] | 1.4 [0.63, 3.11] | 2.44 [0.70, 8.58] |
| Any IADL impairment | 0.53*** [0.27, 1.05] | 1.94 [0.84, 4.52] | 1.77 [0.49, 6.40] |
|
| |||
| Annual primary care visits | |||
| 0–1 | — | — | — |
| 2–3 | 1.21 [0.50, 2.96] | 2.19 [0.76, 6.37] | 0.76 [0.15, 3.80] |
| 4–5 | 1.46 [0.57, 3.76] | 1.05 [0.34, 3.28] | 0.88 [0.17, 4.51] |
| 6+ | 1.66 [0.59, 4.63] | 1.18 [0.33, 4.29] | 0.59 [0.08, 4.51] |
|
| |||
| Annual specialty care visits | |||
| 0–3 | 0.9 [0.45, 1.80] | 1.58 [0.63, 3.94] | 1.99 [0.49, 8.12] |
| 4–8 | — | — | — |
| 9+ | 1.15 [0.61, 2.15] | 1.17 [0.57, 2.41] | 1.88 [0.48, 7.28] |
|
| |||
| Number of medications taken daily | |||
| 0–2 | — | — | — |
| 3–6 | 0.89 [0.46, 1.75] | 1.09 [0.49, 2.41] | 1.47 [0.37, 5.87] |
| 7+ | 1.26 [0.51, 3.15] | 0.88 [0.31, 2.48] | 1.21 [0.18, 7.97] |
|
| |||
| Monthly medication costs | |||
| $0–$9 | — | — | — |
| $10–$49 | 1.26 [0.64, 2.45] | 0.83 [0.34, 2.03] | 0.45 [0.11, 1.82] |
| $50+ | 0.96 (0.43, 2.13] | 0.72 [0.26, 1.99] | 0.93 [0.2, 4.07] |
|
| |||
| Annual emergency department visits | |||
| 0–1 | — | — | — |
| 2–5 | 0.87 [0.48, 1.58] | 0.61 [0.31, 1.22] | 0.82 [0.24, 2.86] |
| +6 | 0.52 [0.12, 2.15] | 0.59 [0.09, 4.05] | 7.88* [0.90, 69.27] |
|
| |||
| Annual admissions to hospital | |||
| 0–1 | — | — | — |
| 2–5 | 0.91 [0.48, 1.72] | 1.08 [0.46, 2.52] | 2.66 [0.81, 8.70] |
| 6+ | 0.12*** [0.01, 1.14] | 5.05 [0.43, 59.15] | 0.00** [0.00, 0.01] |
|
| |||
| Difficulty paying health care costs | |||
| Not at all | — | — | — |
| Somewhat | 0.63 [0.35, 1.16] | 0.72 [0.31, 1.68] | 1.3 [0.37, 4.53] |
| Difficult | 0.81 [0.22, 2.90] | 2.52 [0.79, 8.03] | 2.28 [0.22, 23.31] |
| Very difficult | 0.47*** [0.20, 1.12] | 1.45 [0.43, 4.89] | 3.12 [0.69, 14.10] |
|
| |||
| Constant | — | 0.08* [0.01, 0.60] | 0.04* [0.00, 0.82] |
|
| |||
| Constants | |||
| Low copay for brand prescription | 0.01* [0.00, 0.04] | — | — |
| Monthly premium | 0.02* [0.00, 0.10] | — | — |
| No hospital deductible | 0.04* [0.01, 0.17] | — | — |
| Access to physicians out-of-network | 0.31 [0.07, 1.39] | — | — |
Note. Adjusted associations between health literacy and Medicare Advantage plan choice were estimated using multinomial logistic regression. Plan C is the comparison choice. ADL= activities of daily living; CI = confidence interval; FFS = fee for service; IADL = instrumental activities of daily living.
*
p < 0.1.
**
p < .05.
***
p < .01.