Article Figures & Data
Tables
- Table 1.
Characteristics of Health Maintenance Organization (HMO) vs Non-HMO Members Among Nonelderly, Insured Adults
Characteristic HMO (n = 15,006) % (95% CI) Non-HMO (n = 16,670) % (95% CI) * P < .01. † P < .001. ‡ P < .05. § Higher scores on the physical health summary score (PCS 12) and the mental health summary score (MCS 12) of the Medical Outcomes Study Short Form 12 health survey indicate better physical or mental health status. Education, years* < 12 9.7 (8.7–10.7) 11.1 (10.3–11.9) 12 33.7 (32.7–34.7) 33.6 (32.4–34.8) 13–15 29.5 (28.5–30.5) 27.5 (26.3–28.7) ≥ 16 27.1 (26.1–28.1) 27.8 (26.8–28.8) Age, years† 18–29 24.0 (23.0–25.0) 21.9 (20.9–22.9) 30–44 44.2 (43.2–45.2) 41.1 (40.9–42.3) 45–64 31.8 (31.7–31.8) 37.0 (35.8–38.2) Male sex‡ 49.0 (48.2–49.8) 48.1 (47.5–48.7) Race† Black 12.8 (10.8–14.8) 9.7 (7.7–11.7) Hispanic, English fluent 7.9 (5.9–9.9) 4.2 (3.0–5.4) Hispanic, non-English fluent 4.2 (3.8–4.6) 2.5 (1.3–3.7) Other race 6.2 (5.4–7.0) 4.8 (4.2–5.4) White 68.9 (67.7–70.1) 78.9 (77.7–80.1) Marital status, single* 37.9 (36.5–39.3) 35.4 (33.8–37.0) Mean family size 2.66 (2.62–2.70) 2.70 (2.64–2.76) Residence† Large metropolitan area 82.3 (79.5–85.1) 66.6 (62.6–70.6) Small metropolitan area 4.3 (3.5–5.1) 7.5 (6.5–8.5) Nonmetropolitan area 13.3 (10.7–15.9) 25.9 (22.5–29.3) Medicaid insurance† 3.3 (2.7–3.9) 8.0 (7.0–9.0) Smoking status Current 25.3 (24.3–26.3) 24.9 (23.7–26.1) Former 21.6 (20.6–22.6) 22.4 (21.4–23.4) Never 53.1 (51.5–54.7) 54.2 (52.6–55.8) Health status PCS 12 (physical) score, mean§ 51.1 (50.9–51.3) 50.8 (50.6–51.0) MCS 12 (mental) score, mean 52.3 (52.1–52.5) 52.3 (52.1–52.5) Income as percent of poverty level† < 100% 14.0 (13.0–15.0) 17.2 (16.0–18.4) 100%–199% 18.1 (16.9–19.3) 16.7 (15.7–17.7) 200%–399% 36.0 (34.8–37.2) 33.3 (32.1–34.5) ≥ 400% 31.9 (30.3–33.5) 32.8 (31.6–34.4) Characteristic Crude Prevalence % (95% CI) Adjusted Prevalence* % (95% CI) * Multivariate analyses adjusted for race-ethnicity, age, sex, income, marital status, family size, community size, smoking, mental health summary score (MCS 12) and physical health summary score (PCS 12) of the Medical Outcomes Study Short Form 12, insurance type (private; Medicaid), health maintenance organization status, and usual source of care. Has usual source of care P = .0001 P =.45 < 12 years 82.9 (80.8–85.0) 85.3 (83.4–87.2) 12 years 85.3 (84.4–86.2) 86.0 (85.2–86.8) 13–15 years 86.9 (85.8–88.0) 86.8 (85.7–87.9) ≥16 years 87.1 (86.3–87.9) 86.0 (85.1–86.9) Physician visit in past year P < .0001 P < .0001 < 12 years 72.3 (70.1–74.5) 72.5 (70.6–74.3) 12 years 76.0 (75.2–76.8) 76.5 (75.7–77.3) 13–15 years 79.8 (78.8–80.8) 79.1 (78.1–80.1) ≥16 years 81.3 (80.3–82.3) 81.2 (80.2–82.2) Mental health visit in past year P =.0001 P < .0001 < 12 years 7.5 (6.3–8.7) 5.3 (4.4–6.2) 12 years 6.7 (6.1–7.3) 6.5 (5.9–7.1) 13–15 years 8.6 (7.8–9.4) 8.7 (8.0–9.4) ≥16 years 8.6 (8.0–9.2) 10.1 (9.4–10.8) Mammogram in past year P < .0001 P = .005 < 12 years 54.3 (49.8–58.8) 57.0 (52.5–61.5) 12 years 61.8 (59.4–64.2) 62.7 (60.3–65.1) 13–15 years 64.0 (60.7–67.3) 63.4 (60.0–66.8) ≥16 years 69.7 (66.8–72.6) 67.5 (64.5–70.5) Influenza vaccination in past year P = .0001 P = .0002 < 12 years 27.1 (22.7–31.5) 27.7 (23.8–31.6) 12 years 37.5 (33.9–41.1) 36.5 (32.9–40.1) 13–15 years 36.2 (32.7–39.7) 36.0 (32.0–40.0) ≥16 years 39.6 (36.2–43.0) 40.9 (37.2–44.6) Smoking cessation advice P = .13 P = .31 < 12 years 50.8 (46.6–55.0) 49.1 (45.0–53.2) 12 years 47.4 (45.0–49.8) 48.0 (45.6–50.4) 13–15 years 47.3 (44.5–50.1) 47.2 (44.4–50.0) ≥16 years 44.4 (41.0–47.8) 44.4 (41.0–47.8) - Table 3.
Relationship Between Health Maintenance Organization (HMO) Status and Health Care Access and Use
Characteristic Crude Prevalence % (95% CI) Adjusted Prevalence* % (95% CI) * Multivariate analyses adjusted for race-ethnicity, age, sex, income, marital status, family size, community size, smoking, mental health summary score (MCS 12) and physical health summary score (PCS 12) of the Medical Outcomes Study Short Form 12, insurance type (private; Medicaid), HMO status, and usual source of care. Has usual source of care P < .0001 P < .0001 HMO 87.5 (86.7–88.3) 88.1 (87.4–88.9) Not HMO 84.7 (83.9–85.5) 84.4 (83.6–85.2) Physician visit in past year P = .0005 P = .001 HMO 79.4 (78.4–80.4)7 9.1 (78.3–79.9) Not HMO 77.1 (76.3–77.9) 77.4 (76.8–78.0) Mental health visit in past year P = .95 P = .92 HMO 7.8 (7.3–8.3) 7.8 (7.3–8.3) Not HMO 7.8 (7.3–8.3) 7.8 (7.3–8.3) Mammogram in past year P = .09 P = .02 HMO 64.8 (62.3–67.3) 65.3 (62.8–67.8) Not HMO 62.0 (60.1–63.9) 61.6 (59.7–63.5) Influenza vaccination in past year P = .24 P = .01 HMO 37.3 (33.2–41.4) 38.5 (35.0–42.0) Not HMO 35.0 (32.8–37.2) 34.3 (31.8–36.9) Smoking cessation advice P = .50 P = .39 HMO 47.9 (45.8–50.0) 48.0 (45.8–50.2) Not HMO 47.00 (45.0–49.0) 46.9 (44.8–49.0) - Table 4.
Adjusted Prevalence of Health Care Access and Use by Education and Health Maintenance Organization (HMO) Status
Educational Level In HMO Not in HMO Note: Multivariate analyses adjusted for race-ethnicity, age, sex, income, marital status, family size, community size, smoking, mental health summary score (MCS 12) and physical health summary score (PCS 12) of the Medical Outcomes Study Short Form 12, insurance type (private; Medicaid), HMO status, and usual source of care. * P values represent tests for significance for interaction between HMO membership and educational level. Has usual source of care,P = .83* < 12 years 86.7 (83.9–89.5) 83.9 (81.7–86.1) 12 years 87.9 (86.8–89.0) 84.4 (83.2–85.6) 13–15 years 88.8 (87.5–90.2) 84.9 (83.4–86.4) >16 years 88.1 (86.9–89.3) 84.2 (82.9–85.5) Physician visit in past year, P = .52* < 12 years 74.6 (71.3–77.9) 70.9 (68.6–73.2 12 years 77.4 (76.1–78.7) 75.6 (74.4–76.8) 13–15 years 80.2 (78.9–81.5) 78.3 (76.9–79.7) >16 years 81.5 (80.1–82.9) 81.0 (79.8–82.2) Mental health visit in past year, P = .06* < 12 years 6.1 (4.6–7.6) 4.8 (3.8–5.8) 12 years 6.7 (6.0–7.4) 6.3 (5.4–7.2) 13–15 years 9.0 (8.0–10.0) 8.4 (7.5–9.3) >16 years 9.2 (8.2–10.2) 10.7 (9.7–11.7) Mammogram in past year, P = .77* < 12 years 61.5 (53.4–69.6) 53.9 (47.2–60.6) 12 years 65.5 (61.5 69.5) 60.7 (57.3–64.1) 13–15 years 64.5 (59.3–69.7) 62.8 (58.2–67.4) >16 years 68.6 (63.2–74.0) 66.8 (63.3–70.3) Influenza vaccination in past year, P = .04* < 12 years 31.7 (25.6–37.8) 25.3 (20.0–30.6) 12 years 35.5 (31.1–39.9) 37.1 (32.9–41.3) 13–15 years 39.7 (33.6–45.8) 33.8 (29.0–38.6 >16 years 47.3 (41.8–52.8) 37.0 (32.7–41.3) Smoking cessation advice, P = .01* < 12 years 54.3 (48.3–60.3) 44.9 (39.4–50.4) 12 years 47.3 (44.0–50.6) 48.7 (45.5–51.9) 13–15 years 49.4 (46.0–52.8) 45.3 (41.5–49.1) >16 years 41.9 (37.0–46.8) 46.8 (42.5–51.1)
