Health & health care of the Medicare population

236 Pages·1992·12.6 MB·English

by  Westat, inc

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EALTH HEALTH CARE OF
6<
THE MEDICARE POPULATION
DATA FROM THE MEDICARE
1992
CURRENT BENEFICIARY SURVEY
NOVEMBER
1996
Authors:
Mary A. Laschober (Westatlnc.) and Gary L. Olin (Westatlnc.)
Produced undercontractto theHealth CareFinancingAdministration,
U.S. DepartmentofHealth andHuman Services,
hy Westat, Inc., 1650ResearchBoulevard, Rockville, Maryland20850-3129
Suggested Citation
Laschober, MaryA. andOlin, Gar^'L. (November 1996). Health&HealthCareoftheMedicare
Population: Datafrom the 1992MedicareCurrentBeneficiary Survey. Rockville, MD: Westat, Inc.
Acknowledgements
MCBSSourcebookCommittee:
Mar\' Bishop, Westat, Inc.
BradEdwards, Westat, Inc.
FranklinJ. Eppig,HealthCare FinancingAdminisfrarion
DavidJudkins, Westat, Inc.
Judith D.Kasper, The]ohnsHopkins University
MichaelRhoads, Westat, Inc.
Renee Slobasky, Westat, Inc.
JosephWaksberg, Westat, Inc.
NicholasZill, Westat, Inc.
StatisticalAdvice:
AdamChu andJulieO'Connell, Westat, Inc.
Technical Editor:
Barbara Brickman, Westat, Inc.
Data Production:
Joan Bull and KevinChung, Westat, Inc.
Table Production:
Janice Braccher, LisaC. Moore, andJamesI. MoulthropJr.,Westat, Inc.
Concept Design:
Ana Horton andJacquelineNemes, Westat, Inc.
Designand Production:
EileenM.Worthingcon, Westat, Inc.
TABLE OF CONTENTS
H
Chapter 1. Introduction and Highlights of Findings 1
H
Chapter 2. A Snapshot of the Medicare Population 7
Demographic characteristics 8
Figure 1 Distribution ofFemale Medicare Beneficiaries by Age Group, 1992 9
Figure 2 Distribution ofthe Medicare Population by Age and Race or Ethnicity, 1992 9
Figure 3 Living Arrangements ofMedicare Beneficiaries Residing in Community Settings, byRace orEthnicity, 1992 10
Economic characteristics 10
Figure 4 Distribution ofMedicare Beneficiaries and Income, 1992 11
Figures Mean Income ofMedicare Beneficiaries, by Marital Status and Educational Achievement, 1992 11
Health status 12
Figure 6 Self-Assessed HealthofMedicare Beneficiaries Living in Communities, by Age Group, 1992 12
Figure 7 Distribution ofMedicare Beneficiaries Living in Communities, by Age and Functional Limitations, 1992 12
Accessto care 13
Figure 8 Percent ofMedicare Beneficiaries in CommunitiesWho Reported Positive Responses toAccess Questions, byRace orEthnicity, 1992 .... 13
Figure 9 Percent ofSelected Medicare Beneficiaries in Communities Who Reported Positive Responses to Access Questions, 1992 14
Spending on personal health care 14
Figure 10 Average Personal HealthCare Expenditures ofMedicare Beneficiaries, by Age, Gender, and Residence, 1992 15
Figure 11 Average Personal HealthCare Expenditures by Aged Medicare Beneficiaries, by Functional Limitations and Residence, 1992 15
Satisfaction with health care 15
Figure 12 Distribution ofAged and Disabled Medicare Beneficiaries in Communities Who Were Satisfied withTheir Medical Care, 1992 16
Figure 13 Distribution ofMedicare Beneficiaries in Communities Who Were Satisfied with Their Medical Care, byType ofInsurance, 1992 16
Summary 16
•••
III
TABLE OF CONTENTS
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Chapter 3. Health Care Expenditures by the Aged and Disabled 19
Sourcesoffunding 20
Figure 1 Sources ofPaymentfor Medicare Beneficiary HealthCare, 1992 21
Figure 2 Sources ofPaymentfor HealthCare by Aged and Disabled Medicare Beneficiaries, 1992 21
Expenditures bytype ofservice 21
Figure 3 Medicare Beneficiary Health Care Expenditures byType ofService, 1992 22
Payer contributions bytype ofservice 22
Figure 4 PayerContributionsbyType ofService, 1992 23
Heoitli core consumption byselected groups 23
Figure 5 Distribution ofMedicare Beneficiaries by Residence and Share ofHealth Care Expenditures, 1992 24
Figure 6 Medicare BeneficiaryAverage HealthCare Expenditure by Health Status, 1992 24
Figure 7 Relative Health Care Expenditures ofMedicare Beneficiaries by Health Status, 1992 25
Figure 8 Types ofSupplemental Insurance Used by Medicare Beneficiaries Residing inCommunities, 1992 25
Figure 9 Average Health Care Expenditure by Type ofInsurance for Medicare Beneficiaries Residing in Communities, 1992 26
The burden on households 25
Figure 10 Average Out-of-Pocket Health Care Expenditure for Medicare Beneficiaries, by Residence and Income Range, 1992 27
Summary 27
H
Chapter 4. High-Cost Users of Health Care Services Within the Medicare Population 29
Figure 1 Distribution ofPersonal Health Care Expendituresfor the Medicare Population, 1992 30
Table l.A Personal Health Care Expenditures and Percent ofExpenditures by Medicare Beneficiaries, by Population Percentile, 1992 31
Table l.B Medicare Program Payments and Percent ofPayments by Medicare Beneficiaries, by Population Percentile, 1992 31
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Definition ofa high-cost user 30
Figure 2 Cumulative Distributions ofthe Medicare Population and Personal Health Care Expenditures, 1992 31
Table 2 Percent DistributionofMedicare Beneficiaries and Personal Health Care Expenditures, by Cost Group, 1992 32
Utilization ofservices 32
Figure 3 Medicare Beneficiary Residence Status by Cost Group, 1992 33
Figure 4 Cost Groups by Inpatient Hospital Stays forall Medicare Beneficiaries, 1992 33
Financing of health care 34
Figure 5 Sources ofPaymentforPersonal Health Care Expenditures, byCostGroup, for all Medicare Beneficiaries, 1992 34
Figure 6 Cost Groups by Supplemental Insurance Holdings for Medicare Beneficiaries Living in the Community, 1992 35
High-cost user characteristics 35
Measuresofneed 35
Figure 7 Cost Groups by Self-Reported Health Statusfor all Medicare Beneficiaries, 1992 36
Figure 8 Highest-Cost Users ofMedical Services by Medicare Eligibility Status, for Medicare Beneficiaries Living in the Community, 1992 36
Figure 9 Mortality Status by Cost Group and by Medicare BeneficiaryResidence Status, 1992 37
Figure 10 Highest-Cost Users ofMedical Services by Medicare Eligibility and Residence Status, 1992 38
Enablingfactors 38
Figure 11 Supplemental Insurance Coverage by Cost Group for Medicare Beneficiaries Living in the Community, 1992 39
Figure 12 Income Categories byCost Group for Medicare Beneficiaries Living in the Community, 1992 39
Demographicfactors 39
Figure 13 Medicare BeneficiaryAge by CostGroup for Medicare Beneficiaries Living in the Community, 1992 40
Figure 14 High-Cost Medicare Beneficiaries by Race/Ethnicity, by Selected Characteristics, 1992 40
Summary..;
41
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TABLE OF CONTENTS
Chapters. Detailed Tables from the Medicare Current Beneficiary Survey Data 43
Section 1. Who is in the Medicare population?
Table 1.1 Age, Gender, and Race/Ethnicity ofMedicare Beneficiaries, byResidence Status, 1992 44
Table 1.2 Demographic and Socioeconomic Characteristics ofMedicare Beneficiaries, byAge andbyGender and Age, 1992 48
Table 1.3 Demographic and Socioeconomic Characteristics ofMedicare Beneficiaries, byRace/Ethnicity andAge, 1992 51
Table 1.4a Demographic and Socioeconomic Characteristics ofNoninstitutionalized Medicare Beneficiaries, by Living
Arrangement and Age, 1992 54
Table 1.4b Demographic and Socioeconomic Characteristics ofNoninstitutionalized Male Medicare Beneficiaries, by Living
Arrangement and Age, 1992 56
Table 1.4c Demographic and Socioeconomic Characteristics ofNoninstitutionalized Female Medicare Beneficiaries, by Living
Arrangement andAge, 1992 58
Table 1.5 Demographic and Socioeconomic Characteristics ofInstitutionalized Medicare Beneficiaries, by Age, 1992 60
Table 1.6 Demographic and Socioeconomic Characteristics ofNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, 1992 62
Section 2. How heahhy are Medicare beneficiaries?
Table 2.1 Perceived Health and FunctioningofMedicare Beneficiaries, byAge andby Gender andAge, 1992 66
Table 2.2 Self-Reported Health Conditions and RiskFactors ofMedicare Beneficiaries, byAge andbyGender andAge, 1992 68
Table 2.3 Perceived Health and FunctioningofMedicare Beneficiaries, by Race/Ethnicity andAge, 1992 70
Table 2.4 Self-Reported Health Conditions and Risk Factors ofMedicare Beneficiaries, by Race/Ethnicity and Age, 1992 72
Table 2.5a Perceived Health and FunctioningofNoninstitutionalized Medicare Beneficiaries, by LivingArrangement and Age, 1992 74
Table 2.5b PerceivedHealthand FunctioningofInstitutionalized Medicare Beneficiaries, byAge, 1992 76
Table 2.6a Self-Reported Health Conditions and Risk Factors ofNoninstitutionalized Medicare Beneficiaries, by Living
Arrangement and Age, 1992 78
Table 2.6b Reported Health Conditions and Risk Factors ofInstitutionalized Medicare Beneficiaries, byAge, 1992 80
Table 2.7 Perceived Health and Functioning ofNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, 1992 82
Table 2.8 Self-Reported Health Conditions and Risk Factors ofNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, 1992 84
Section 3. What health care services do Medicare beneficiaries receive?
Table 3.1 Inpatient Hospital UserRates forNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, and by Demographic,
Socioeconomic, and Health Characteristics, 1992 86
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Table 3.2 Outpatient Hospital UserRates forNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, and by Demographic,
Socioeconomic, and Health Characteristics, 1992 90
Table 3.3 Physician/SupplierServicesUserRatesforNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, and by
Demographic, Socioeconomic, and Health Characteristics, 1992 94
Table 3.4 Dental Services UserRates forNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, and by Demographic,
Socioeconomic, and Health Characteristics, 1992 98
Table 3.5 Prescription Medicine UserRates forNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, and by Demographic,
Socioeconomic, and Health Characteristics, 1992 102
Table 3.6 Facility UserRates forMedicare Beneficiaries, by Insurance Coverage, and by Demographic, Socioeconomic, and Health
Characteristics, 1992 106
Section 4. How much does the Medicare population spend on heahh care and who pays for their care?
Table 4-1 Personal Health Care Expendituresfor Medicare Beneficiaries, by Source ofPayment andType ofMedical Service, 1992 110
Table 4-2 Inpatient Hospital Expenditures forNoninstitutionalized Medicare Beneficiaries, by Source ofPayment, and by Demographic,
Socioeconomic, and HealthCharacteristics, 1992 113
Table 4-3 Outpatient Hospital Expenditures forNoninstitutionalized Medicare Beneficiaries, by Source ofPayment, and by Demographic,
Socioeconomic, and HealthCharacteristics, 1992 117
Table 4-4 Physician/Supplier Services Expenditures forNoninstitutionalized Medicare Beneficiaries, by Source ofPayment, and by
Demographic, Socioeconomic, and Health Characteristics, 1992 121
Table 4-5 Dental Services Expenditures forNoninstitutionalized Medicare Beneficiaries, by Source ofPayment, and by Demographic,
Socioeconomic, and HealthCharacteristics, 1992 125
Table 4-6 Prescription Medicine ExpendituresforNoninstitutionalized Medicare Beneficiaries, by Source ofPayment, and by Demographic,
Socioeconomic, and Health Characteristics, 1992 129
Table 4.7 Long-Term Care Facility Expenditures forMedicare Beneficiaries, by Source ofPayment, and by Demographic, Socioeconomic,
and Health Characteristics, 1992 133
Table 4-8 Personal Health Care Expenditures perNoninstitutionalized Medicare Beneficiary, by Insurance Coverage, and by Demographic,
Socioeconomic, and HealthCharacteristics, 1992 136
Table 4-9 Inpatient Hospital Expenditures forNoninstitutionalized Medicare Beneficiaries perUser, by Insurance Coverage, and by
Demographic, Socioeconomic, and Health Characteristics, 1992 140
Table 4.10 Outpatient Hospital ExpendituresforNoninstitutionalized Medicare Beneficiaries perUser, by Insurance Coverage, and by
Demographic, Socioeconomic, and Health Characteristics, 1992 144
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Table 4.11 Physician/Supplier Services Expenditures forNoninstitutionalized Medicare Beneficiaries perUser, by Insurance Coverage,
and by Demographic, Socioeconomic, and Health Characteristics, 1992 148
Table 4-12 Prescription Medicine ExpendituresforNoninstitutionalized Medicare BeneficiariesperUser, by Insurance Coverage, and
by Demographic, Socioeconomic, and Health Characteristics, 1992 152
Table 4-13 Inpatient Hospital Expenditures forNoninstitutionalized Medicare Beneficiaries perUser, by Source ofPayment, and by
Demographic, Socioeconomic, and Health Characteristics, 1992 156
Table 4-14 Outpatient Hospital ExpendituresforNoninstitutionalized Medicare Beneficiaries perUser, by Source ofPayment, and by
Demographic, Socioeconomic, and Health Characteristics, 1992 160
Table 4T5 Physician/Supplier Services Expenditures forNoninstitutionalized Medicare Beneficiaries perUser, by Source ofPayment,
and by Demographic, Socioeconomic, and Health Characteristics, 1992 164
Table 4-16 Dental Services ExpendituresforNoninstitutionalized Medicare Beneficiaries perUser, by Source ofPayment, and by
Demographic, Socioeconomic, and HealthCharacteristics, 1992 168
Table 4-17 Prescription Medicine ExpendituresforNoninstitutionalized Medicare Beneficiaries perUser, by Source ofPayment, and
by Demographic, Socioeconomic, and Health Characteristics, 1992 172
Section 5. What isthe Medicare population's accessto care and howsatisfied are theywith their care?
Table 5.1 Indicators ofAccess to Care forNoninstitutionalized Medicare Beneficiaries, byAge and by Gender and Age, 1992 176
Table 5.2 Measures ofSatisfaction with Care forNoninstitutionalized Medicare Beneficiaries, byAge and by Gender and Age, 1992 178
Table 5.3 Indicators ofAccess to Care forNoninstitutionalized Medicare Beneficiaries, by Race/Ethnicity and Age, 1992 180
Table 5.4 Measures ofSatisfactionwith Care forNoninstitutionalized Medicare Beneficiaries, byRace/Ethnicity and Age, 1992 182
Table 5.5 Indicators ofAccess to Care forNoninstitutionalized Medicare Beneficiaries, by Living Arrangement and Age, 1992 184
Table 5.6 Measures ofSatisfactionwithCareforNoninstitutionalized Medicare Beneficiaries, byLivingArrangement andAge, 1992 186
Table 5.7 Indicators ofAccess to CareforNoninstitutionalized Medicare Beneficiaries, byHealth Status, 1992 188
Table 5.8 Measures ofSatisfactionwith Care forNoninstitutionalized Medicare Beneficiaries, by Health Status, 1992 190
Table 5.9 Indicators ofAccess to Care forNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, 1992 192
Table 5.10 Measures ofSatisfaction with Care forNoninstitutionalized Medicare Beneficiaries, by Insurance Coverage, 1992 194