*Address correspondence to Nancy A. Miller, Department of Public Policy, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore MD 21250. E-mail:
Gerontologist. 2014 Jun;54(3):473-87. doi: 10.1093/geront/gnt012. Epub 2013 Mar 12.
We extend research to examine relations between gender, disability, and age in the receipt of preventive services.
We pool Medical Expenditure Panel Survey data for years 2001-2007. Using logit models, we examine the relations between gender, disability, and age and the receipt of preventive services.
For most services, both women and men with disabilities had higher probabilities of receiving preventive services relative to those without disabilities. There was a pattern of more significant differences for men relative to women. Predicted probabilities for receipt of services were significantly higher among older adults relative to younger adults. A usual source of care was a significant predictor across services. For example, we estimate that adults aged 18-64 with a place as a usual source of care received 59% of recommended services, whereas those with a person as a source of care received 63% of services relative to 47% for those without a usual source of care. Among older adults, the predicted percentage of preventive services received for no usual source of care was 52% and that for a place or a person as a usual source of care were 71% and 76%, respectively. Across gender, disability, and age, receipt of a range of clinical preventive services is suboptimal.
Policy actions that may mitigate the differences we observed include mechanisms to support access to a usual source of care, financial incentives to enhance the receipt of preventive services, and implementation of community-based prevention services with attention to their linkage to clinical care.
我们扩展研究范围，考察性别、残疾和年龄在获得预防服务方面的关系。
我们汇集了 2001-2007 年医疗支出调查数据。使用逻辑回归模型，我们检验了性别、残疾和年龄与接受预防服务之间的关系。
对于大多数服务，残疾男性和女性获得预防服务的可能性相对较高，与非残疾者相比。男性的差异更为显著。与年轻人相比，老年人接受服务的预测概率显著更高。通常的医疗服务提供者是各服务的显著预测因素。例如，我们估计，18-64 岁有固定医疗服务提供者的成年人接受了 59%的推荐服务，而有个人作为医疗服务提供者的成年人接受了 63%的服务，而没有固定医疗服务提供者的成年人接受了 47%的服务。在老年人中，没有通常的医疗服务提供者的预测接受预防服务的百分比为 52%，而有地方或个人作为通常的医疗服务提供者的百分比分别为 71%和 76%。在性别、残疾和年龄方面，一系列临床预防服务的接受程度并不理想。
我们观察到的差异可能通过以下政策行动来缓解，包括支持获得通常的医疗服务提供者的机制、提供经济激励以促进预防服务的接受，以及实施关注与临床护理联系的社区预防服务。
