Age differences in ratings of medical care among older adults living in the community

Patients' ratings of care serve as an indicator of quality of care, as well as a predictor of patient behavior. In spite of the heterogeneity of the older population and their disproportionate consumption of health care resources, relatively little attention has been paid to assessing the elderly's satisfaction with medical care. Using data from the 1991 Medicare Current Beneficiary Survey, we compare ratings of medical care and quality of physician care between the young-old (65-79 years) and old-old (80+ years) living in the community. Multivariate logistic regression analyses are performed to assess the independent effect of age on patients' ratings of care. Results show a significant negative association between age and highly positive ratings of care in the elderly; the old-old are less likely than the young-old to give very favorable opinions (e.g., very satisfied vs other) of the care they received. The relationship remains even after controlling for measures of health status and experience and use of health care. However, variations were observed when more negative ratings (e.g., satisfied/very satisfied vs dissatisfied/very dissatisfied) were considered. Although elderly people as a group usually are found to rate their care more positively than younger adults, this study indicates there is heterogeneity in the older population regarding views of medical care.