Surprisingly little current, population-level detail exists regarding companion accompaniment for health care among Medicare beneficiaries, particularly by race/ethnicity. For respondents in the 2013 Medicare Current Beneficiary’s Survey Access to Care public use data (N = 12,253), multivariable models predicted accompaniment to the doctor by race/ethnicity, adjusting for confounders. Chi square analyses compared, by race/ethnicity, who was accompanying and why. Overall, 37.5% of beneficiaries had accompaniment. In multivariable analyses, non-Hispanic blacks (OR 1.18; 95% CI 1.03–1.36) and Hispanics (OR 1.47; 95% CI 1.25–1.74) were significantly more likely than non-Hispanic whites to have accompaniment. Over 35% of all three groups had someone to “take notes,” “ask questions,” and/or “explain things,” which did not vary by race/ethnicity; significant differences were seen for “explain instructions,” “translate,” and “moral support.” Hispanics had the highest percentages for all three. Many Medicare beneficiaries have accompaniment to doctors’ appointments, particularly in minority racial/ethnic groups, which should be considered in policy and practice.
Medicare Race/ethnicity Caregiving Health communication
Howard DL, et al. Distribution of African Americans in residential care/assisted living and nursing homes: More evidence of racial disparity? Am J Public Health. 2002;92:1272–7.CrossRefPubMedPubMedCentralGoogle Scholar
McCann JJ, et al. Comparison of informal caregiving by black and white older adults in a community population. J Am Geriatr Soc. 2000;48:1612–7.CrossRefPubMedGoogle Scholar
Navaie-Waliser M, et al. The experiences and challenges of informal caregivers: common themes and differences among whites, blacks, and Hispanics. Gerontologist. 2001;41:733–41.CrossRefPubMedGoogle Scholar
Betancourt JR, et al. Guide to preventing readmissions among racially and ethnically diverse Medicare beneficiaries. Prepared by the disparities solutions center, mongan institute for health policy at massachusetts general hospital. Baltimore, MD: Centers for Medicare & Medicaid Services Office of Minority Health; 2015.Google Scholar
Ishikawa H, et al. Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters. Soc Sci Med. 2005;60:2307–20.CrossRefPubMedGoogle Scholar
Kuluski K, et al. A qualitative descriptive study on the alignment of care goals between older persons with multi-morbidities, their family physicians and informal caregivers. BMC Fam Pract. 2013;14:133.CrossRefPubMedPubMedCentralGoogle Scholar
Rosland AM, et al. Family and friend participation in primary care visits of patients with diabetes or heart failure: patient and physician determinants and experiences. Med Care. 2011;49:37–45.CrossRefPubMedPubMedCentralGoogle Scholar
von Elm E, et al. STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344–9. doi:10.1016/j.jclinepi.2007.11.008.CrossRefGoogle Scholar
Retooling for an Aging America: Building the Health Care Workforce. Patients and Informal Caregivers. Institute of Medicine (US) Committee on the Future Health Care Workforce for Older Americans. Washington DC: National Academies Press (US); 2008. Available from: https://www.ncbi.nlm.nih.gov/books/NBK215403/. Accessed 4 Apr 2017.
Clayman ML, et al. Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. Soc Sci Med. 2005;60:1583–91.CrossRefPubMedGoogle Scholar
Rosland AM, et al. Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help? Chronic Illn. 2010;6:22–33.CrossRefPubMedPubMedCentralGoogle Scholar
Bookwala J, Marshall KI, Manning SW. Who needs a friend? Marital status transitions and physical health outcomes in later life. Health Psychol. 2014;33:505–15.CrossRefPubMedGoogle Scholar