Article Figures & Data
Tables
- Table 1. Characteristics of the Study Population and Comparison of Those Still Alive with Those Who Died
Characteristics All Alive Dead P Age category (years) 782 65–74 453 341 (75%) 112 (25%) 75–84 282 161 (57%) 121 (43%) 85+ 47 12 (26%) 35 (74%) 0.0001 Sex Male 338 210 (62%) 1,286 (37%) Female 444 304 (68%) 140 (32%) 0.07 Race White 668 445 (67%) 223 (33%) Nonwhite 114 73 (64%) 41 (36%) 0.59 Marital status Married 272 151 (56%) 121 (44%) Other 504 364 (72%) 140 (28%) 0.0001 Income <$15,000/year 141 81 (57%) 60 (43%) $15,000–$35,000/year 342 218 (64%) 124 (36%) >$35,000/year 276 202 (73%) 74 (27%) 0.0028 Education Less than high school 123 76 (62%) 47 (38%) High school 194 137 (71%) 57 (29%) More than high school 465 305 (66%) 160 (34%) 0.24 Confidant Present 105 64 (61%) 41 (39%) Absent 674 452 (67%) 2,221 (33%) 0.22 ADL score 0–13 264 148 (56%) 116 (44%) 14 518 370 (71%) 148 (29%) 0.0001 IADL score 0–13 233 115 (49%) 118 (51%) 14 549 403 (73%) 146 (27%) 0.0001 Health (self-rated) Poor 12 2 (17%) 10 (83%) Fair 117 62 (53%) 55 (47%) Good 304 184 (61%) 120 (40%) Very good 265 203 (77%) 62 (23%) Excellent 84 67 (80%) 17 (20%) 0.0001 Continuous Variables N Mean (SD) Mean (SD) P Value Age 782 72.4 (5.3) 76.7 (6.6) 0.0001 BMI 769 29.0 (5.3) 28.1 (5.9) 0.035 Alive Dead N Mean (SD) Mean (SD) P Value SF-36 General Health 775 68.2 (17.5) 58.0 (19.6) <0.0001 Health (0 to 100) 733 79.1 (15.5) 70.4 (18.1) <0.0001 QWB-SA (0–1) 775 0.65 (0.12) 0.60 (0.13) <0.0001 CPCI Comprehensive (0–6) 778 5.0 (0.6) 5.0 (0.7) 0.63 Accumulated knowledge (0–6) 780 4.8 (0.8) 4.7 (0.9) 0.45 Communication (0–6) 772 4.8 (0.8) 4.7 (0.8) 0.045 Preference for regular doctor (0–6) 782 5.0 (0.7) 5.1 (0.7) 0.34 Coordination (0–6) 780 4.3 (0.9) 4.4 (0.9) 0.09 Advocacy (0–6) 780 5.0 (0.6) 5.1 (0.6) 0.16 Family (0–6) 725 4.2 (1.4) 4.1 (1.4) 0.14 Community (0–6) 774 4.4 (1.3) 4.4 (1.4) 0.78 UPC (0–1) 779 0.62 (0.3) 0.57 (0.3) 0.016 Total CPCI (0–49) 757 38.3 (5.3) 38.1 (5.4) 0.73 Years with PCP mean (SD) 775 10.5 (8.7) 10.5 (9.0) 0.54 ADL, activities of daily living; IADL, independent activities of daily living; BMI, body mass index; QWB-SA, Quality of Well-Being Self-administered Scale; UPC, proportion of care from PCP; CPCI, Components of Primary Care Index (scale 0–5 for subscales, 0–40 for total); PCP, primary care physician; Years with PCP, duration of current primary care PCP–participant relationship in years.
- Table 2. Characteristics of ‘Severity of Illness’ Subgroups, ADL + IADL <27 (0–28); ADL + IADL >26 and >4 PCP Visits/Year, and ADL + IADL >26 and <5 PCP Visits per Year
>Categorical Variables Disabled Nondisabled High Users Low Users P 185 197 400 Age (years) 65–74 11 (27%) 11 (27%) 19 (46%) 75–84 87 (18%) 121 (26%) 264 (56%) 85+ 87 (32%) 65 (24%) 117 (44%) 0.0006 Sex Female 57 (17%) 84 (25%) 197 (58%) Male 128 (29%) 113 (25%) 203 (57%) 0.002 Race White 153 (23%) 168 (25%) 347 (52%) Nonwhite 32 (28%) 29 (29%) 53 (53%) 0.43 Marital status Married 74 (27%) 70 (26%) 128 (47%) Other 107 (21%) 125 (25%) 272 (54%) 0.11 Income <$15,000 50 (35%) 34 (24%) 57 (40%) $15,000–$35,000/year 81 (24%) 90 (26%) 171 (50%) >$35,000/year 49 (18%) 67 (24%) 160 (58%) 0.0010 Education Less than high school 43 (35%) 25 (20%) 55 (45%) High school 43 (22%) 61 (31%) 90 (46%) More than high school 99 (21%) 111 (24%) 255 (55%) 0.0038 Confidant Present 33 (31%) 26 (25%) 46 (44%) Absent 150 (22%) 170 (25%) 354 (53%) 0.10 Health Poor 10 (83%) 0 (0%) 2 (17%) Fair 62 (53%) 29 (25%) 26 (22%) Good 80 (26%) 83 (27%) 141 (46%) Very good 21 (8%) 67 (25%) 177 (67%) Excellent 12 (14%) 18 (21%) 54 (64%) 0.0001 Morbidity Index 1.79 (1.18) 1.46 (1.08) 1.07 (0.92) Continuous variables BMI 30.84 (6.55) 28.96 (5.32) 28.02 (4.98) 0.0002 Rating (0–100) 65.09 (17.59) 76.02 (14.93) 81.17 (15.07) <0.0001 QWB-SA (0–1) 0.53 (0.12) 0.64 (0.11) 0.67 (0.11) <0.0001 MOS SF-36 General Health (0–100) 50.38 (18.36) 64.30 (15.83) 71.57 (16.50) <0.0001 Emotional Health (0–100) 75.32 (17.56) 78.30 (15.92) 82.30 (14.55) <0.0001 Years with current PCP 10.0 (9.1) 11.4 (8.8) 10.1 (8.6) 0.81 Median 7 10 8 PCP visits* 5.7 (4.3) 8.4 (5.3) 2.6 (1.1) <0.0001 Median 5 6 3 Other visits to practice* 0.80 (1.53) 0.90 (1.7) 0.47 (1.11) 0.0002 Median 0 0 0 Other healthcare visits* 5.5 (7.8) 4.2 (4.9) 2.8 (4.2) <0.001 Median 4 3 2 ED visit rate* 0.59 (1.71) 0.21 (0.46) 0.11 (0.36) <0.001 Median 0.12 0 0 Hospitalization rate (SD) 0.45 (0.94) 0.21 (0.46) 0.11 (0.33) <0.0001 Median 0.06 0 0 Deaths (N; %) 100 (54.1) 63 (32.0) 101 (25.3) <0.0001 Survival time 7.4 (3.4) 8.7 (2.9) 9.1 (2.6) <0.0001 Comprehensiveness 5.02 (0.69) 5.19 (0.61) 4.97 (0.63) 0.1112 Accumulated knowledge 4.80 (0.93) 5.00 (0.77) 4.58 (0.86) 0.0002 Communication 4.65 (0.90) 4.86 (0.78) 4.76 (0.77) 0.28 Preference for regular doctor 5.12 (0.69) 5.23 (0.63) 5.00 (0.65) 0.0006 Coordination 4.48 (0.86) 4.59 (0.82) 4.19 (0.91) <0.0001 Advocacy 5.10 (0.67) 5.22 (0.60) 4.98 (0.59) 0.0031 Considers family context 4.27 (1.39) 4.35 (1.38) 4.01 (1.37) 0.0141 Community 4.52 (1.30) 4.47 (1.32) 4.34 (1.28) 0.3545 UPC 0.55 (0.27) 0.67 (0.21) 0.59 (0.29) 0.002 Total CPCI 38.5 (5.7) 39.6 (5.1) 37.4 (5.2) 0.0018 ADL, activities of daily living; IADL, independent activities of daily living; PCP, primary care physician; BMI, body mass index; QWB-SA, Quality of Well-Being Self-administered Scale; MOS, Medical Outcomes Study; ED, emergency department; UPC, proportion of care from PCP; CPCI, Components of Primary Care Index (scale 0–5 for subscales, 0–40 for total).
- Table 3. Longitudinal Growth Curve Model for HRQoL (QWB-SA) within Severity of Illness Subgroups (CPCI Scores Were Not Transformed)
Independent Variables Parameter Estimate (SE) F Statistic P Disabled Age −0.002 (0.001) 2.59 0.11 Sex (female) 0.02 (0.02) 0.68 0.41 Marital status (married) −0.001 (0.02) 0.00 0.96) Education (compared with more than high school) 0.38 0.69 Less than high school −0.01 (0.02) High school 0.01 (0.02) Income (compared with >$35,000) 0.90 0.41 <$15,000 −0.03 (0.03) $15,000–$35,000 −0.0003 (0.02) Body mass index 0.001 (0.001) 0.44 0.51 General Health (SF-36) 0.002 (0.0005) 25.81 <0.0001 Morbidity Index −0.02 (0.01) 4.29 0.04 Visits with other providers −0.003 (0.005) 0.41 0.52 Years with current PCP −0.0001 (0.001) 0.01 0.91 CPCI* Comprehensive(0–6) 0.001 (0.01) 0.01 0.93 Accumulated knowledge(0–6) 0.003 (0.01) 0.08 0.78 Communication(0–6) 0.004 (0.01) 0.22 0.64 Preference for regular doctor (0–6) −0.01 (0.01) 0.66 0.42 Coordination (0–6) −0.01 (0.01) 0.47 0.49 Advocacy (0–6) −0.01 (0.01) 0.25 0.62 Family (0–6) 3.32 e−6(0.01) 0.00 0.90 Community (0–6) 0.01 (0.01) 0.90 0.34 UPC (0–1) 0.05 (0.03) 2.84 0.09 Total CPCI (0–49) 0.0004 (0.002) 0.06 0.81 Nondisabled, high users Age −0.003 (0.001) 3.83 0.05 Sex (female) −0.008 (0.02) 0.29 0.59 Marital status (married) 0.009 (0.02) 0.23 0.63 Education (compared with more than high school) Less than high school 0.029 (0.02) High school 0.007 (0.02) Income (compared with >$35,000) 0.35 0.71 <$15,000 −0.02 (0.03) $15,000–$35,000 −0.01 (0.02) Body mass index −0.003 (0.001) 3.85 0.05 General Health (SF-36) 0.003 (0.0005) 26.31 <0.0001 Morbidity Index −0.01 (0.01) 2.58 0.11 Visits with other providers −0.01 (0.004) 2.82 0.09 Years with current PCP 0.0004 (0.0009) 0.16 0.69 CPCI* Comprehensive (0 to 6) −0.01 (0.01) 0.22 0.64 Accumulated knowledge (0 to 6) −0.002 (0.01) 0.04 0.85 Communication (0–6) −0.002 (0.01) 0.05 0.83 Preference for regular doctor (0–6) −0.01 (0.01) 0.42 0.52 Coordination (0–6) 0.002 (0.01) 0.03 0.86 Advocacy (0–6) −0.01 (0.01) 0.99 0.32 Family (0–6) 0.01 (0.01) 4.30 0.04 Community (0–6) −0.01 (0.01) 1.57 0.21 UPC (0–1) 0.01 (0.04) 0.05 0.83 Total CPCI (0–49) −0.0005 (0.002) 0.09 0.77 Nondisabled, low users Age −0.003 (0.0009) 10.43 0.001 Sex (female) 0.02 (0.01) 2.65 0.10 Marital status(married) 0.02 (0.01) 2.31 0.13 Education (compared with more than high school) 1.45 0.24 Less than high school 0.020 (0.02) High school 0.02 (0.01) Income (compared with >$35,000) 0.28 0.76 <$15,000 −0.01 (0.02) $15,000–$35,000 −0.01 (0.01) Body mass index −0.002 (0.001) 2.74 0.10 General Health (SF-36) 0.002 (0.0003) 39.06 <0.0001 Morbidity Index −0.01 (0.005) 6.91 0.009 Visits with other providers 0.002 (0.003) 0.68 0.41 Years with current PCP 0.001 (0.001) 2.09 0.15 CPCI* Comprehensive (0–6) −0.01 (0.01) 0.94 0.33 Accumulated knowledge (0–6) −0.003 (0.01) 0.29 0.59 Communication (0–6) 0.01 (0.01) 1.52 0.22 Preference for regular doctor (0–6) −0.001 (0.01) 0.01 0.94 Coordination (0–6) 0.01 (0,01) 4.04 0.05 Advocacy (0–6) −0.002 (0.01) 0.04 0.84 Family (0–6) 0.003 (0.004) 0.67 0.41 Community (0–6) −0.002 (0.004) 0.23 0.63 UPC (0–1) 0.04 (0.02) 5.19 0.02 Total CPCI (0–49) 0.0005 (0.001) 0.25 0.62 ↵* CPCI total and subscale scores were entered separately (10 separate models are represented).
HRQoL, health-related quality of life; QWB-SA, Quality of Well-Being Self-administered Scale; CPCI, Components of Primary Care Index (scale 0–5 for subscales, 0–40 for total); PCP, primary care physician; UPC, proportion of care from PCP.
Independent Variables Hazard Ratio (95% CI) χ2 Statistic P Disabled Age 1.07 (1.03–1.11) 12.4 0.0004 Sex (female) 0.54 (0.31–0.95) 4.53 0.033 Marital status (married) 0.69 (0.40–1.18) 1.83 0.18 Education 0.92 (0.68–1.23) 0.33 0.56 Income 1.08 (0.76–1.54) 0.17 0.68 Body mass index 0.98 (0.94–1.01) 1.56 0.21 General Health (SF-36) 0.99 (0.98–1.00) 2.76 0.10 Morbidity Index 1.02 (0.84–1.23) 0.043 0.84 Visits with other providers 0.84 (0.69–1.02) 3.09 0.079 Years with current PCP 1.00 (0.97–1.02) 0.062 0.80 CPCI* Comprehensive (0–6) 1.11 (0.77–1.60) 0.32 0.57 Accumulated knowledge (0–6) 1.03 (0.78–1.37) 0.046 0.83 Communication (0–6) 1.02 (0.79–1.31) 0.023 0.88 Preference for regular doctor (0–6) 1.01 (0.72–1.40) 0.0011 0.97 Coordination (0–6) 1.20 (0.86–1.66) 1.16 0.28 Advocacy (0–6) 1.24 (0.82–1.87) 1.05 0.30 Family (0–6) 1.07 (0.89–1.29) 0.57 0.45 Community (0–6) 1.08 (0.90–1.30) 0.74 0.39 UPC (0–1) 1.94 (0.83–4.54) 2.33 0.13 Total CPCI (0–49) 1.02 (0.98–1.08) 0.93 0.33 Nondisabled, high users Age 1.10 (1.05–1.16) 14.1 0.0002 Sex (female) 0.26 (0.13–0.51) 15.0 0.0001 Marital status (married) 0.34 (0.17–0.66) 10.0 0.0016 Education 1.21 (0.78–1.87) 0.74 0.39 Income 1.02 (0.62–1.68) 0.0069 0.93 Body mass index 0.98 (0.92–1.04) 0.58 0.45 General Health (SF-36) 0.98 (0.96–1.00) 4.17 0.041 Morbidity Index 1.50 (1.16–1.93) 9.43 0.0021 Visits with other providers 1.08 (0.98–1.25) 0.95 0.33 Years with current PCP 1.01 (0.98–1.05) 0.79 0.37 CPCI* Comprehensive (0–6) 1.07 (0.67–1.69) 0.075 0.78 Accumulated knowledge (0–6) 1.18 (0.76–1.83) 0.53 0.47 Communication (0–6) 1.01 (0.68–1.50) 0.001 0.98 Preference for regular doctor (0–6) 1.29 (0.82–2.05) 1.20 0.27 Coordination (0–6) 1.43 (0.99–2.07) 3.58 0.058 Advocacy (0–6) 1.86 (1.09–3.17) 5.11 0.024 Family (0–6) 0.93 (0.73–1.17) 0.43 0.51 Community (0–6) 1.05 (0.82–1.33) 0.13 0.71 UPC (0–1) 0.69 (0.19–2.59) 0.30 0.58 Total CPCI (0–49) 0.48 (0.13–1.80) 1.18 0.28 Nondisabled, low users Age 1.07 (1.03–1.10) 13.0 0.0003 Sex (female) 0.55 (0.33–0.90) 5.56 0.018 Marital status (married) 0.54 (0.31–0.92) 5.04 0.025 Education 1.47 (1.06–2.04) 5.28 0.022 Income 0.75 (0.53–1.05) 2.81 0.094 Body mass index 1.00 (0.96–1.05) 0.013 0.91 General Health (SF-36) 0.98 (0.97–1.00) 6.25 0.013 Morbidity Index 1.22 (0.98–1.50) 3.26 0.071 Visits with other providers 0.86 (0.70–1.05) 2.13 0.14 Years with current PCP 0.99 (0.97–1.02) 0.24 0.63 CPCI* Comprehensive (0–6) 0.86 (0.61–1.23) 0.67 0.41 Accumulated knowledge (0–6) 0.81 (0.62–1.05) 2.64 0.10 Communication (0–6) 0.79 (0.61–1.02) 3.27 0.071 Preference for regular doctor (0–6) 1.13 (0.84–1.54) 0.64 0.42 Coordination (0–6) 0.91 (0.72–1.14) 0.72 0.40 Advocacy (0–6) 0.95 (0.66–1.35) 0.099 0.75 Family (0–6) 0.92 (0.77–1.09) 1.00 0.32 Community (0–6) 0.90 (0.76–1.06) 1.68 0.20 UPC (0–1) 0.51 (0.23–1.13) 2.76 0.096 Total CPCI (0–49) 0.97 (0.93–1.02) 1.53 0.22 ↵* CPCI total and subscale scores were entered separately (10 separate models are represented).
PCP, primary care physician; CPCI, Components of Primary Care Index (scale 0–5 for subscales, 0–40 for total); UPC, proportion of care from PCP.
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