Table 5.
Differences in care satisfaction and health status between traditional Medicare and Medicare Advantage beneficiaries with and without Alzheimer disease and related dementias.
| Adjusted predictions, mean (95% CI)a | ||||||
|---|---|---|---|---|---|---|
| With ADRD | Without ADRD | |||||
| Outcomes | TM beneficiaries | MA beneficiaries | Differences among MA beneficiaries relative to TM beneficiaries | TM beneficiaries | MA beneficiaries | Differences among MA beneficiaries relative to TM beneficiaries |
| Care satisfactionb | ||||||
| Quality of medical care (n = 25533) | 3.8 (3.8 to 3.7) | 3.9 (3.8 to 3.9) | 0.1 (0.0 to 0.1) | 3.8 (3.7 to 3.8) | 3.8 (3.7 to 3.8) | −0.0 (−0.1 to 0.1) |
| OOP costs for medical care (n = 34274) | 3.7 (3.6 to 3.7) | 3.6 (3.6 to 3.7) | 0.0 (−0.1 to 0.1) | 3.7 (3.6 to 3.7) | 3.5 (3.4 to 3.7) | −0.1 (−0.4 to 0.1) |
| Available care by specialists (n = 32777) | 3.5 (3.5 to 3.6) | 3.6 (3.6 to 3.7) | 0.1 (−0.0 to 0.2) | 3.5 (3.4 to 3.6) | 3.6 (3.5 to 3.7) | 0.1 (−0.1 to 0.3) |
| Follow-up after initial treatments (n = 33389) | 3.5 (3.4 to 3.5) | 3.5 (3.4 to 3.6) | 0.0 (−0.1 to 0.1) | 3.4 (3.3 to 3.5) | 3.2 (3.1 to 3.4) | −0.2 (−0.4 to 0.0) |
| Physician’s concern for overall health (n = 31423) | 3.8 (3.8 to 3.8) | 3.9 (3.8 to 3.9) | 0.1 (0.0 to 0.1) | 3.8 (3.7 to 3.8) | 3.8 (3.7 to 3.8) | 0.0 (−0.1 to 0.1) |
| Health statusb | ||||||
| General health status compared to same-age people (n = 46859) | 2.7 (2.6 to 2.7) | 2.7 (2.6 to 2.8) | 0.0 (−0.1 to 0.1) | 3.2 (3.2 to 3.3) | 3.1 (3.0 to 3.2) | −0.1 (−0.2 to −0.1) |
| Overall health status compared to a year ago (n = 46970) | 0.6 (0.6 to 0.6) | 0.6 (0.6 to 0.7) | 0.0 (−0.0 to 0.1) | 0.8 (0.8 to 0.8) | 0.8 (0.8 to 0.8) | −0.0 (−0.1 to 0.0) |
Abbreviations: ADRD, Alzheimer disease and related dementias; TM, traditional Medicare; MA, Medicare Advantage; OOP, out-of-pocket.
a
A two-stage least square regression model was used and county-level MA penetration was used as an instrument. Both stages adjusted the standard errors for clustering within county.
b
A higher value indicates better care satisfaction or health status.