Assessment of Sensory Impairment and Health Care Satisfaction Among Medicare Beneficiaries

This cross-sectional study assesses the association between hearing, vision, or dual sensory impairment and patient satisfaction with quality of care, communication from health professionals, and access to care among a nationally representative sample of Medicare beneficiaries. Question What is the association between hearing, vision, or dual sensory impairment and dissatisfaction with health care among Medicare beneficiaries? Findings In this cross-sectional study including 10783 Medicare beneficiaries, people with dual sensory impairment were more likely to report dissatisfaction with quality of care, communication from health care professionals, and access to care, and those with hearing and vision impairment were more likely to report dissatisfaction with the information given by health care professionals than those without sensory impairments. Meaning Addressing sensory impairment across health care settings via quality initiatives and environmental modifications may represent an area of intervention to improve health care satisfaction. Importance Satisfaction with care is associated with improved quality of care and health outcomes. Sensory impairment can be a barrier to effective communication and access to care, and this may result in reduced satisfaction with care. Objective This study examined the association between sensory impairment and health care satisfaction among Medicare beneficiaries. Design, Setting, and Participants This cross-sectional study used data from the 2017 Medicare Current Beneficiary Survey (MCBS), a nationally representative in-person survey of Medicare beneficiaries. Functional sensory impairment was categorized as no sensory impairment, hearing impairment, vision impairment, and dual sensory impairment. Patient dissatisfaction included responses on quality of care, ease to get to a doctor, out-of-pocket costs paid, information given, and doctors' concern with overall health rather than an isolated symptom or disease. Exposures Self-reported functional sensory impairment. Main Outcomes and Measures Multivariable-adjusted odds ratios (ORs) of the association between dissatisfaction with care and sensory impairment. Results A total of 10783 respondents representing 44736889 Medicare beneficiaries (8944 [85.3%] aged >= 65 years, 5733 [52.9%] women, and 8195 [75.5%] non-Hispanic White) were included. Dual sensory impairment compared with no sensory impairment was associated with the highest odds of dissatisfaction across outcomes, including quality of care (OR, 1.52; 95% CI, 1.12-2.08). Compared with no sensory impairment, having dual sensory impairment (OR, 1.82; 95% CI, 1.40-2.37), hearing impairment (OR, 1.67; 95% CI, 1.29-2.17), or vision impairment (OR, 1.56; 95% CI, 1.18-2.08) were associated with dissatisfaction with the information provided about what was wrong. Those with hearing impairment (OR, 1.38; 95% CI, 1.03-1.86) or dual sensory impairment (OR, 2.03; 95% CI, 1.55-2.66) were more likely to be dissatisfied with doctors' concern with overall health compared with those with no sensory impairment. Having dual sensory impairment or vision impairment only was associated with greater odds of dissatisfaction with ease to get to a doctor (dual sensory: OR, 1.69; 95% CI, 1.24-2.30; vision: OR, 1.63; 95% CI, 1.14-2.31) and out-of-pocket costs paid (dual sensory: OR, 1.27; 95% CI, 1.04-1.54; vision: OR, 1.31; 95% CI, 1.07-1.61). Conclusions and Relevance These findings contribute to the growing body of literature on sensory impairment and patient satisfaction and have implications for health care system planning and spending to provide patient-centered care for older adults.