Thesis
The intersection of age and eligibility: variation in health services use for medicare beneficiaries
Washington State University
Master of Health Policy and Administration (MHPA), Washington State University
2010
Handle:
https://hdl.handle.net/2376/101835
Abstract
Objective: The purpose of this thesis is to assess variation in health services use and factors contributing to that use for Medicare beneficiaries divided both by original eligibility and age. Background: Originally established in 1965 to address the problem of hospital coverage for uninsured seniors, Medicare expanded its eligibility and increased covered services significantly over the following decades (Marmor, 2000). Currently, individuals can qualify for Medicare through their Social Security retirement benefits (SSA), Social Security Disability Insurance (SSDI) benefits, or a diagnosis of end-stage renal disease (ESRD). SSA benefits are only available to those 65 and older, while ESRD and SSDI benefits are for those under age 65. Existing younger/older comparisons neglect the fact that younger beneficiaries become older beneficiaries and remain within the program. Additionally, ESRD-eligible beneficiaries are generally removed from these comparisons. When subsumed into the category of older beneficiaries, the unique characteristics of these former SSDI and ESRD beneficiaries may obscure the true degree of difference between retirees and younger beneficiaries. Methods: This was a secondary analysis of the Medicare Current Beneficiary Survey 2007 Access to Care database. Beneficiaries were sorted into one of five groups by entitlement and age: ESRD under age 65, former ESRD age 65 and older, SSDI under age 65, former SSDI age 65 and older, and retirees. Group classification served as the independent variable for the statistical analyses. Control and dependent variables were derived from the MCBS Access to Care Codebook and grouped into the four major areas of predisposing characteristics, enabling resources, evaluated/perceived need, and perceived access/actual use in accordance with the behavioral model of health services use (Andersen, 1995). Results: Analyses revealed significant levels of variation between the five groups for variables in each of the domains contributing to health services use. Significant variation was also seen among the five groups on measures of perceived access and actual use. Conclusion: The findings of this thesis support the assertion that dividing the Medicare beneficiary population both by original eligibility and age is necessary to meaningfully assess the health services use of Medicare beneficiaries and the factors influencing that use.
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Details
- Title
- The intersection of age and eligibility
- Creators
- Elizabeth Geneva Blodgett
- Contributors
- Jae J. Kennedy (Degree Supervisor)
- Awarding Institution
- Washington State University
- Academic Unit
- Health Policy and Administration, Department of
- Theses and Dissertations
- Master of Health Policy and Administration (MHPA), Washington State University
- Publisher
- Washington State University; Pullman, Wash. :
- Identifiers
- 99900525050801842
- Language
- English
- Resource Type
- Thesis