Quality of life in Medicaid patients 50 and over




Large, Stephanie
Mathew, Susan
Richardson, Janice
Gamboa, Adriana
Vintimilla, Raul
Connally, Patrica
O'Jile, Judith R.
Johnson, Leigh
O'Bryant, Sid


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Introduction: Mighty Care is a community-based geriatric primary care program designed to reach Medicaid eligible adults and elders who are 50 and above, with the purpose of increasing access to care and improve patient quality of life. This is a new initiative for UNTHSC that utilizes mobile teams and clinics to increase access to care by providing appropriate levels of care within the community where the patients live. Generally, research indicates that as people age their quality of life (QOL) declines. The purpose of this study is to do a preliminary analysis of the QOL of the patients seen through this program, and examine age related differences in scores. Methods: QOL was assessed using the 36-item short form health survey (SF-36). The SF 36 is a widely used tool, and possesses good psychometric properties. The SF 36 consists of eight domains, which make up the physical and mental health composite scales. Descriptive statistics were calculated to compare the scores from our sample to the national means. To examine the impact of age, we split the sample into two groups: those 64 and under and 65 and older. Independent t test were used to examine the impact of the age groups on QOL scores. Results: The sample consisted of 229 patients (53 males and 176 females) with a mean age of 61. The average of PCS was 34.78 (SD= 9.87) and MCS was 45.075, falling slightly below the national average. For physical health there was a significant difference in the scores between the two groups, t (227) =-2.458, p=.015, with participants 64 and below (M= 33.7, SD=9.27) having lower scores that the 65 and above group (M=37.15, SD=10.84). For the mental health scores, there was a significant difference between the two groups, t (227)=-3.934, p= .000; suggesting that participants 64 and below (M= 42.71, SD= 13.66) had lower scores those over 65 (M=50.18, SD=12.18). Conclusion: Past research has indicated that age decreases scores on the physical and mental health scales. However, these results indicated that individuals 65 and older reported better QOL than their younger counterparts. One potential explanation for these findings has to do with the fact that at 65 most of these patients are able to apply for Medicare. All participants in this program have Medicaid, however as an individual reaches 65 they are considered dually eligible which means they can have both Medicare and Medicaid. This gives this population access to a wider array of health services and benefits. The data is from baseline QOL measures in the Mighty Care program. This study had a small sample size, therefore more data is needed.