Access to Care and Functional Status Change Among Aged Medicare Beneficiaries

Porell, Frank W.; Miltiades, Helen B.

doi:10.1093/geronb/56.2.s69

Cited by 42 publications

(43 citation statements)

References 73 publications

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“…These results confirmed prior research showing the negative effects of chronic illnesses (Porell & Miltiades, 2001;Shaw & Krause, 2001). Therefore, hypothesis 1 could not be rejected.…”

Section: Resultssupporting

confidence: 91%

“…The OARS Chronic Illness Index (George & Fillenbaum, 1985) indicated if participants had any of the following 10 chronic illnesses over the past year: arthritis, asthma, emphysema, hypertension, heart trouble, diabetes, urinary tract problems, cancer, stroke, and orthopedic problems. Similar illness indices were supported in prior research as part of their research methodologies (Porell & Miltiades, 2001;Shaw & Krause, 2001). Scores ranged from 0 to 10 diseases, mean = 2.1, SD = 1.25.…”

Section: Methodssupporting

confidence: 69%

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Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

2006

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The goal of this study was to examine stress-ameliorating effects of religiosity, spirituality, and healthy lifestyle behaviors on the stressful relationship of chronic illness and the subjective physical well-being of 221 older adults. We also investigated whether the intervening variables functioned as coping behaviors and orientations or as adaptations in late life. Guided by the stress paradigm, path analysis was used to assess these relationships in a stress suppressor model and a distress deterrent model. No suppressor effects were found; however a number of distress deterrent relationships were detected. Spirituality, physical activities, and healthy diet all contributed to higher subjective physical well-being, as counter-balancing effects, in the distress deterrent model. The findings have implications for future research on the role of spirituality, religiosity and lifestyle behaviors on the well-being of chronically ill older adults. Findings also support the need for studying different dimensions of religiosity and spirituality in an effort to understand coping versus adaptation in behaviors and orientations.

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“…These results confirmed prior research showing the negative effects of chronic illnesses (Porell & Miltiades, 2001;Shaw & Krause, 2001). Therefore, hypothesis 1 could not be rejected.…”

Section: Resultssupporting

confidence: 91%

Section: Methodssupporting

confidence: 69%

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

2006

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“…55 There are generally few race and rurality differences in health care use among persons aged 65 years and older after need is taken into account. 23,56 Optimistically, less severe declines in disability and functional health status over time have been found among Black and Hispanic older adults than among Whites, with distance to care (proxy for rural) having no significant effect.…”

Section: Rural Racial/ethnic Minorities and Access To Carementioning

confidence: 99%

Person and Place: The Compounding Effects of Race/Ethnicity and Rurality on Health

Probst

Moore²,

Glover³

et al. 2004

Am J Public Health

289

264

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Rural racial/ethnic minorities constitute a forgotten population. The limited research addressing rural Black, Hispanic, and American Indian/Alaska Native populations suggests that disparities in health and in health care access found among rural racial/ethnic minority populations are generally more severe than those among urban racial/ethnic minorities. We suggest that disparities must be understood as both collective and contextual phenomena. Rural racial/ethnic minority disparities in part stem from the aggregation of disadvantaged individuals in rural areas. Disparities also emerge from a context of limited educational and economic opportunity. Linking public health planning to the education and economic development sectors will reduce racial/ethnic minority disparities while increasing overall well-being in rural communities.

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“…Additionally, we examined the potential enabling role of supplemental health insurance for elders who want or need to implement functional adaptations. This expanded examination of enabling characteristics builds on intriguing new research showing that extraindividual factors such as access to care and health insurance are associated with greater odds of survival and reduced likelihood of transitioning from independence to disability among Medicare beneficiaries (Porell & Miltiades, 2001). We are building on this new research studying the effects of extraindividual enabling factors and making a significant innovation in that our outcome of interest is use of functional adaptations instead of functional ability.…”

Section: Need and Enabling Characteristicsmentioning

confidence: 99%

Maintaining Functional Independence in Elderly Adults

Mathieson

Kronenfeld²,

Keith

2002

The Gerontologist

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Purpose:We investigated whether health status (i.e., need characteristics) and financial resources (i.e., enabling characteristics) were important predictors of two types of functional adaptations among elderly adults: home modifications such as putting nonslip tape on rugs or installing more telephones and use of equipment for mobility or activities of daily living (ADLs) such as canes or walkers. Design and Methods: Participants were identified from the National Survey of Self-Care and Aging ( n ϭ 3,485), a nationally representative sample of noninstitutionalized U.S. adults aged 65 and older. Need and enabling characteristics were used to predict home modifications and equipment use in multinomial logistic analysis, controlling for predisposing characteristics. Results: Although several health-status (need) variables had significant, direct effects on functional adaptations, the effects of ADL limitations were diminished at higher levels of impairment. Among the financial (enabling) variables, subjective income measures and supplemental insurance had significant, direct effects on functional adaptations. Implications: Promotion of functional adaptations among elderly people may benefit from both a proactive approach that targets elders with few limitations and a consideration of financial factors in addition to health status.

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Access to Care and Functional Status Change Among Aged Medicare Beneficiaries

Cited by 42 publications

References 73 publications

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

Person and Place: The Compounding Effects of Race/Ethnicity and Rurality on Health

Maintaining Functional Independence in Elderly Adults

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