An examination of self-reported chronic conditions and health status in the 2001 Medicare Health Outcomes Survey

Objectives: To estimate the prevalence of chronic conditions in managed care-enrolled Medicare seniors (age 65 years plus) and to examine the association between self-reported chronic conditions and health status, as measured by the SF-36. Methods: Data were obtained from the 2001 Medicare Health Outcomes Survey (HOS). The HOS is conducted to assess the quality of care provided to Medicare beneficiaries enrolled in managed care. The survey questionnaire, which was administered by phone or mail, includes the SF-36 and items addressing demographic characteristics, depressive symptoms, and chronic conditions. The SF-36 produces eight multi-item scale scores and physical and mental component summary scores. For this analysis, an ordinary least squares regression model was conducted using the SF-36 scales and summary scores as dependent variables to estimate the association between each chronic condition and the scale scores after adjusting for demographic variables. Results: More than three-fourths of the respondents had at least one chronic condition. Among the conditions, hypertension (56.6%), arthritis of the hip or knee (39.7%), and arthritis of the hand or wrist (33.3%) were the most commonly reported. Compared with other variables, age and arthritis were most highly associated with the SF-36 measures reflective of physical health. Depressive symptoms had the strongest association with the SF-36 measures most reflective of mental health. Among the chronic conditions, the adverse impact of having difficulty in controlling urination, a relatively neglected condition, was only second to depressive symptoms in its negative relationship with vitality, social-functioning, and mental health. Conclusion: Chronic conditions were commonly reported among the older adults. The unique associations found between chronic conditions and domains of health status demonstrate the importance of examining the burden of these conditions in terms of functioning and well-being. The findings of this study may help inform decision making at the patient, health plan, and societal levels.