Quality of health care for older women: what do we know? 2006

Beth Kosiak, and Judy Sangl, and Rosaly Correa-de-Araujo
Agency for Healthcare Research and Quality, Rockville, Maryland, USA. bkosiak@auanet.org

As the proportion of the population age 65 and over continues to grow--to a projected 20.5% or 77.2 million by the year 2040--tracking the quality, access, and receipt of care for older women becomes more important, since the majority of older citizens are women. This article establishes a rough baseline for the quality of care, primarily preventive care, received by older women compared to older men, using selected measures and data of the 2004 National Healthcare Quality Report and National Healthcare Disparities Report. It highlights significant differences between women and men, as well as differences for racial, ethnic, and educational subgroups. Generally, older non-Hispanic white women frequently score higher than their Hispanic and non-Hispanic black counterparts, and more educated women often score significantly higher than their less-educated peers on several measures of quality of care. Compared to their male counterparts, older women are significantly less likely to have any colorectal screening test, to keep high blood pressure under control, and to receive aspirin or beta-blockers upon hospital admission or discharge for acute myocardial infarction. Results are mixed for the process measures related to diabetes, but improvements are clearly needed toward increased rates of eye and foot examinations. Rates of influenza and pneumococcal vaccinations are low but can be improved through Medicare-covered services. We also found that older women are screened less often for breast cancer than those ages 40 to 64. There is still a pervasive lack of knowledge in the research and clinical communities about the unique health care needs of and appropriate processes of care for older adults. More research needs to focus on the quality of care for this growing population in order to allow the development of geriatric-based quality measures and models of care that will set the standards of healthcare for older adults in general, and older women in particular.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011314 Preventive Health Services Services designed for HEALTH PROMOTION. Health Services, Preventive,Preventive Health,Preventive Health Care,Preventive Health Programs,Preventive Programs,Services, Preventive Health,Care, Preventive Health,Health Care, Preventive,Health Program, Preventive,Health Programs, Preventive,Health Service, Preventive,Health, Preventive,Preventive Health Program,Preventive Health Service,Preventive Program,Program, Preventive,Program, Preventive Health,Programs, Preventive,Programs, Preventive Health,Service, Preventive Health
D011787 Quality of Health Care The levels of excellence which characterize the health service or health care provided based on accepted standards of quality. Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D001741 Black or African American A person having origins in any of the black racial groups of Africa (https://www.federalregister.gov/documents/1997/10/30/97-28653/revisions-to-the-standards-for-the classification-of-federal-data-on-race-and-ethnicity). In the United States it is used for classification of federal government data on race and ethnicity. Race and ethnicity terms are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies. African American,African Americans,African-American,Afro-American,Afro-Americans,Black Americans,Blacks,Negroes,African-Americans,Negro,Afro American,Afro Americans,American, African,American, Black,Black American
D005260 Female Females
D006297 Health Services Accessibility The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others. Access To Care, Health,Access to Care,Access to Contraception,Access to Health Care,Access to Health Services,Access to Medications,Access to Medicines,Access to Therapy,Access to Treatment,Accessibility of Health Services,Availability of Health Services,Contraception Access,Contraceptive Access,Medication Access,Accessibility, Health Services,Contraceptive Availability,Health Services Geographic Accessibility,Program Accessibility,Access to Cares,Access to Contraceptions,Access to Medication,Access to Medicine,Access to Therapies,Access to Treatments,Access, Contraception,Access, Contraceptive,Access, Medication,Accessibilities, Health Services,Accessibility, Program,Availability, Contraceptive,Care, Access to,Cares, Access to,Contraception, Access to,Contraceptive Accesses,Health Services Availability,Medication Accesses,Medication, Access to,Medicine, Access to,Medicines, Access to,Therapy, Access to,Treatment, Access to
D006299 Health Services for the Aged Services for the diagnosis and treatment of diseases in the AGED and the maintenance of health in the ELDERLY. Age-Friendly Health Care,Age-Friendly Health Services,Age-Friendly Health Systems,Geriatric Health Care,Geriatric Health Services,Geriatric Health Systems,Health Care for the Aged,Health Systems for the Aged,Health Services for Aged,Health Services for the Elderly,Health Services, Geriatric,Age Friendly Health Care,Age Friendly Health Services,Age Friendly Health Systems,Age-Friendly Health Cares,Age-Friendly Health Service,Age-Friendly Health System,Care, Age-Friendly Health,Care, Geriatric Health,Cares, Age-Friendly Health,Cares, Geriatric Health,Geriatric Health Cares,Geriatric Health Service,Geriatric Health System,Health Care, Age-Friendly,Health Care, Geriatric,Health Cares, Age-Friendly,Health Cares, Geriatric,Health Service, Age-Friendly,Health Service, Geriatric,Health Services, Age-Friendly,Health System, Age-Friendly,Health System, Geriatric,Health Systems, Age-Friendly,Health Systems, Geriatric,Service, Age-Friendly Health,Service, Geriatric Health,Services, Age-Friendly Health,Services, Geriatric Health,System, Age-Friendly Health,System, Geriatric Health,Systems, Age-Friendly Health,Systems, Geriatric Health
D006630 Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race (https://www.federalregister.gov/documents/1997/10/30/97-28653/revisions-to-the-standards-for-the-classification-of-federal-data-on-race-and-ethnicity). In the United States it is used for classification of federal government data on race and ethnicity. Race and ethnicity terms are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies. Cuban Americans,Hispanic Americans,Latin Americans, US,Latinas,Latinos,Latinx,Puerto Ricans,Spanish Americans,Hispanics,American, Hispanic,American, US Latin,Cuban American,Hispanic American,Hispanic or Latinos,Latin American, US,Latina,Latino,Puerto Rican,Spanish American,US Latin American,US Latin Americans
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations

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