Senior Vice President, Health Services, Peoples Health

Dissertation Title

The burden of chronic conditions on self-reported health status in a medicare advantage plan population.

Dissertation Abstract

This dissertation was a multi-staged research study with two goals. The first goal was to assess survey respondents' characteristics to better understand the influence of the characteristics on the validity of self-reported survey responses. Second, the study analyzed the relationship between certain chronic conditions and survey participants' responses to questions related to their overall physical health and mental health to further understand the burden of chronic conditions on self- reported survey responses.

Secondary data derived from a patient satisfaction survey in a Medicare Advantage plan was used to test hypotheses related to response accuracy, the influence of respondent characteristics and the influence of chronic conditions using logistic and multinomial regression analyses. Ten respondent characteristics and nine chronic conditions were used as covariates. Resource dependence theory served as the theoretical construct for hypotheses developed in this study.

Findings indicated that the total number of chronic conditions, total number of prescription medications, and assistance in survey completion significantly influenced the agreement between self-reported number of chronic conditions and the claims data. Respondent characteristics of age, race, having assistance in survey completion, total chronic conditions and total number of medications significantly influenced the agreement between self-reported number of prescription medications and claims data.

Six chronic conditions; dementia, diabetes, congestive heart failure, cerebrovascular disease, coronary artery disease, and rheumatoid arthritis were significant predictors of the likelihood of a self-reported status of worsening overall physical health. Four chronic conditions; dementia, diabetes, coronary artery disease, and decubitus were predictors for the likelihood of a self-reported status of worsening overall mental health.

Findings from this study provide insight into characteristics that influence accuracy in survey responses and the influence of chronic conditions on the assessment of one's rating of their physical health and mental well-being.