Social determinants of health and utilization of transitional and chronic care management services among Medicare beneficiaries: a case-control study.
Background and Objectives The Centers for Medicare & Medicaid Services launched transitional care management (TCM) and chronic care management (CCM) services to improve care coordination. However, the social determinants of health (SDOH) that affect access to these services remain poorly understood....
| Published in: | Gerontologist Vol. 66; no. 7; pp. 1 - 8 |
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| Main Authors: | , , , , , |
| Format: | Article |
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Oxford University Press / USA
Jul2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195281440&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195281440 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Jul2026 vid: 66 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195281440 10.1093/geront/gnag113 ppf: 1 ppct: 7 formats: tig: atl: Social determinants of health and utilization of transitional and chronic care management services among Medicare beneficiaries: a case-control study. aug: au: Park, Chan Mi Kim, Eunji G Luo, Lan Shi, Sandra M McCarthy, Ellen P Kim, Dae Hyun affil: Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, United StatesDivision of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, United States su: Centers for Medicare & Medicaid Services (U.S.) Health services accessibility Social determinants of health Medicare Sex distribution Food security Economic status Communities Population geography Age distribution Transportation Chronic diseases Case-control method Rural conditions Metropolitan areas Social support Educational attainment Medical care costs Activities of daily living Medical care use Mathematical variables Research funding T-test (Statistics) Long-term health care Logistic regression analysis Socioeconomic disparities in health Shopping Continuum of care Functional status Chi-squared test Descriptive statistics Transitional care Odds ratio Longitudinal method Surveys Research Confidence intervals Treatment delay (Medicine) Medical care for older people Meals Data analysis software Neighborhood characteristics sug: subj: Health services accessibility Social determinants of health Medicare Sex distribution Food security Economic status Communities Population geography Age distribution Transportation Chronic diseases Case-control method Rural conditions Metropolitan areas Social support Educational attainment Medical care costs Activities of daily living Centers for Medicare & Medicaid Services (U.S.) Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) Other support activities for transportation All Other Support Activities for Transportation Other Individual and Family Services Medical care use Mathematical variables Research funding T-test (Statistics) Long-term health care Logistic regression analysis Socioeconomic disparities in health Shopping Continuum of care Functional status Chi-squared test Descriptive statistics Transitional care Odds ratio Longitudinal method Surveys Research Confidence intervals Treatment delay (Medicine) Medical care for older people Meals Data analysis software Neighborhood characteristics keyword: Care coordination chronic care coordination of care copyrightHolder:The Gerontological Society of America copyrightYear:2026 Health disparities Health services utilization https://dx.doi.org/10.1093/geront/gnag113 inLanguage:en medicare Medicare beneficiaries publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42166741/ social determinants of health transition of care transportation Care coordination chronic care coordination of care copyrightHolder:The Gerontological Society of America copyrightYear:2026 Health disparities Health services utilization https://dx.doi.org/10.1093/geront/gnag113 inLanguage:en medicare Medicare beneficiaries publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42166741/ social determinants of health transition of care transportation ab: Background and Objectives The Centers for Medicare & Medicaid Services launched transitional care management (TCM) and chronic care management (CCM) services to improve care coordination. However, the social determinants of health (SDOH) that affect access to these services remain poorly understood. Research Design and Methods We included Medicare Current Beneficiary Survey participants from 2016 to 2020. 6 SDOH domains: Economic stability; Social support and community; Healthcare access; Transportation; Education; and Neighborhood environment were measured. We performed a conditional logistic regression to model receipt of TCM or CCM as a function of the 6 SDOH domains and covariates. Results 682 TCM cases were matched to 1,364 controls, and 362 CCM cases were matched to 724 controls. Compared to controls, TCM recipients were older (mean [ SD ] age, 76.3 [ SD 10.9] vs 70.9 [13.2] years), as were CCM recipients (74.4 [10.5] vs 73.2 [10.6] years). Greater social disadvantage was associated with lower odds of TCM receipt. Specifically, poorer healthcare access (tertile 2 vs 0: OR 0.61, 95% CI 0.42–0.88) and rural residence (OR 0.48, 95% CI 0.34–0.68) were associated with reduced TCM use. In contrast, greater economic instability (per 1− SD increase: OR 1.16, 95% CI 0.97–1.38) and transportation barriers (OR 1.16, 95% CI 0.99–1.36) were associated with higher odds of CCM use. Discussion and Implications SDOH has divergent associations with TCM and CCM utilization, revealing potential inequities in access to timely post-discharge care, with CCM may be reaching more socially vulnerable individuals. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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