Morbidity and older persons' perceptions of the quality of their primary care

Efrat Shadmi, Cynthia M. Boyd, Chun Ju Hsiao, Martha Sylvia, Alyson B. Schuster, Chad Boult

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: To quantify the association between community-dwelling older persons' level of morbidity and their perceptions of the quality of their primary care. DESIGN: Cross-sectional study. SETTING: Urban primary care practice. PARTICIPANTS: A sample of community-dwelling members of a capitated health plan aged 65 and older who were patients of four general internists in one urban practice (N=120). MEASUREMENTS: The Johns Hopkins Adjusted Clinical Groups case-mix system was used to designate a person's aggregate morbidity level as moderate or high depending on the number and types of chronic conditions they had. Aspects of quality of primary care (physician-patient communication, interpersonal treatment, knowledge of patient, integration of care, and trust in physician) were assessed using the Primary Care Assessment Survey. RESULTS: All participants were classified as having moderate (41%) or high morbidity (59%). Older adults with high morbidity assigned a lower rating to all aspects of quality of primary care (physician-patient communication (P=.001), interpersonal treatment (P=.002), knowledge of patient (P=.03), integration of care (P=.004), and trust in physician (P=.01)) than those with moderate morbidity. The differences in quality of primary care remained statistically significant after controlling for age, sex, race, and education level. CONCLUSION: Older persons with multiple chronic conditions report inadequate quality of primary care and dissatisfaction with their care. Those with high morbidity levels experience poorer quality of primary care than those with moderate morbidity in all five aspects measured here.

Original languageEnglish
Pages (from-to)330-334
Number of pages5
JournalJournal of the American Geriatrics Society
Issue number2
StatePublished - Feb 2006


  • Multiple morbidity
  • Primary care
  • Quality

ASJC Scopus subject areas

  • Geriatrics and Gerontology


Dive into the research topics of 'Morbidity and older persons' perceptions of the quality of their primary care'. Together they form a unique fingerprint.

Cite this