Characteristics of the Medical Expenditure Panel Survey Participants and Independent Predictors of Shared Decision Making, 2002–2014
| Characteristic | Mean Value (95% CI) or % (95% CI)a | Association With SDM Composite Score,b Points | |
|---|---|---|---|
| 2002 (n=12,138) | 2014 (n=9,049) | ||
| SDM composite score, points | 4.4 (4.3–4.4) | 5.0 (4.9–5.1) | n/a |
| Age, y | 49.3 (48.8–49.8) | 51.8 (51.1–52.5) | 0.01c |
| Femaled | 59.6 (58.8–60.4) | 59.1 (58–60.1) | 0.06c |
| Race/ethnicity | |||
| Non-Hispanic white | 76.3 (74.8–77.8) | 71.7 (69.4–74.0) | Referent |
| Hispanic | 8.5 (7.5–9.5) | 10.8 (9.3–12.3) | −0.03 |
| Non-Hispanic black | 10.2 (9.2–11.2) | 10.8 (9.4–12.1) | 0.33c |
| Non-Hispanic Asian | 3.0 (2.4–3.6) | 4.0 (3.1–5.0) | −0.29c |
| Non-Hispanic other or multiple | 2.0 (1.5–2.5) | 2.7 (2.0–3.4) | 0.08 |
| Census region | |||
| Northeast | 21.3 (19.6–23.1) | 18.3 (16.5–20.0) | Referent |
| Midwest | 24.1 (22.1–26.0) | 23.0 (21.2–24.8) | 0 |
| South | 34.3 (32.1–36.5) | 37.2 (35.0–39.5) | −0.01 |
| West | 20.3 (18.5–22.0) | 21.5 (19.8–23.1) | −0.21c |
| Partner status | |||
| Married/partnered | 60.9 (59.5–62.3) | 57.6 (55.8–59.4) | Referent |
| Widowed | 8.8 (8.1–9.4) | 8.3 (7.5–9.1) | 0.10c |
| Divorced/separated | 12.8 (12.0–13.6) | 14.0 (12.9–15.0) | 0.05c |
| Never married | 17.6 (16.7–18.5) | 20.2 (18.9–21.4) | −0.03 |
| Education | |||
| <High school | 19.4 (18.3–20.4) | 11.2 (10.3–12.1) | Referent |
| High school/GED/some college | 54.1 (52.9–55.2) | 57.5 (55.9–59.2) | −0.09c |
| Bachelor’s degree | 15.8 (14.9–16.8) | 18.8 (17.6–20.0) | −0.19c |
| >Bachelor’s degree | 10.7 (9.9–11.5) | 12.5 (11.3–13.6) | −0.26c |
| Health insurance coverage | |||
| Any private | 77.7 (76.4–79.0) | 71.9 (70.2–73.6) | Referent |
| Public only | 16.2 (15.1–17.3) | 23.6 (22.1–25.1) | 0.04 |
| Uninsured | 6.1 (5.5–6.8) | 4.5 (3.8–5.1) | −0.17c |
| Perceived health status | |||
| Excellent | 21.2 (20.2–22.3) | 21.2 (19.9–22.5) | Referent |
| Very good | 32.8 (31.7–34.0) | 32.2 (30.7–33.6) | −0.32c |
| Good | 28.9 (27.9–30.0) | 28.9 (27.6–30.3) | −0.41c |
| Fair | 11.9 (11.2–12.7) | 13.3 (12.3–14.2) | −0.33c |
| Poor | 5.1 (4.6–5.6) | 4.4 (3.9–5.0) | −0.15c |
| Usual source of care is same race/ethnicityd | 41.1 (39.2–43.0) | 36.3 (34.0–38.6) | 0.24c |
| Employedd | 66.5 (65.2–67.8) | 63.6 (62.0–65.2) | −0.09c |
| Currently smoked | 19.3 (18.3–20.2) | 13.1 (12.1–14.1) | 0.02 |
| Need help with ADLe | 3.9 (3.4–4.3) | 4.4 (3.8–4.9) | 0.20c |
| Need help with iADLe | 7.0 (6.4–7.7) | 7.5 (6.8–8.3) | 0.13c |
| SF-12 PCS scoref | 47.0 (46.7–47.3) | 47.1 (46.7–47.5) | 0.03c |
| SF-12 MCS scoref | 50.3 (50.1–50.6) | 51.1 (50.8–51.4) | 0.04c |
| Body mass index, kg/m2 | 27.4 (27.3–27.6) | 28.6 (28.4–28.8) | 0.01c |
| Family income as % of poverty line | |||
| Poor/negative (<100%) | 9.8 (9.0–10.6) | 11.5 (10.4–12.6) | Referent |
| Near poor (100% to 124%) | 3.6 (3.2–4.0) | 4.4 (3.9–5.0) | 0 |
| Low income (125% to 199%) | 12.1 (11.3–12.9) | 11.4 (10.5–12.4) | 0 |
| Middle income (200% to 399%) | 29.5 (28.2–30.8) | 27.4 (25.9–29.0) | −0.06c |
| High income (≥400%) | 45.0 (43.3–46.6) | 45.2 (43.2–47.3) | −0.01 |
| Chronic diseased | |||
| Hypertension | 25.8 (24.7–26.9) | 38.7 (36.9–40.5) | 0.03 |
| Hyperlipidemia | 14.2 (13.3–15.0) | 31.6 (30.1–33.1) | −0.04 |
| Depression | 11.1 (10.4–11.8) | 14.7 (13.7–15.7) | 0.13c |
| Diabetes | 9.9 (9.2–10.6) | 16.4 (15.4–17.5) | 0.10c |
| COPD | 6.5 (6.0–7.1) | 9.0 (8.1–10.0) | −0.01 |
| CAD/MI | 6.8 (6.2–7.3) | 10.1 (9.3–11.0) | 0.07c |
| Cancerg | 6.5 (5.9–7.1) | 9.7 (8.9–10.5) | 0.01 |
| Asthma | 6.0 (5.5–6.4) | 8.9 (8.2–9.7) | −0.05 |
| Arthritis | 2.4 (2.1–2.7) | 13.6 (12.5–14.8) | −0.02 |
| Number of chronic diseasesh | |||
| 0 | 44.9 (43.7–46.1) | 34.0 (32.3–35.6) | Referent |
| 1 | 27.8 (26.9–28.7) | 21.4 (20.3–22.5) | 0.07c |
| 2 | 15.2 (14.4–15.9) | 17.0 (15.9–18.1) | 0.10c |
| ≥3 | 12.2 (11.3–13.1) | 27.7 (26.3–29.1) | 0.11 |
| Total annual health care expenditure, $ | 4,677.6 (4,502.3–4,852.8) | 7,950.2 (7,501.6–8,398.8) | 0 |
| Office visits, No. | 8.4 (8.1–8.7) | 9.6 (9.2–10.0) | 0 |
ADL = activities of daily living; CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; GED = General Educational Development Test; iADL = instrumental activities of daily living; MCS = mental component summary; MI = myocardial infarction; n/a = not applicable; PCS = physical component summary; SDM = shared decision making; SF-12 = 12-item Short Form Health Survey.
↵a Percentages may not sum to 100 because of rounding.
↵b Multivariate linear regression of SDM_Composite = β0 + β1Year + β2Covariates..., where Year is points per year and Covariates are all of the variables in the Table. The unit for the association is SDM composite score points, out of 7 points. For example, a black participant’s SDM composite score had 0.34 additional points compared with a white participant’s, all else constant. For year, coefficient is 0.04 points per year (P <.01).
↵c P <.05.
↵d Referent is the converse.
↵e Three-part screening question to determine if respondent required assistance with ADLs or iADLs.
↵f Possible scores range from 0 to 100. Higher scores represent better self-reported health.
↵g All except nonmelanoma skin cancer.
↵h Out of the 20 conditions considered chronic by the Health and Human Services Office of the Assistant Secretary of Health.