Multiple risk factors and the likelihood of patient-physician communication and health maintenance services in medicare health plans.

This study examined both individual and combined effects of race, education, and health-based risk factors on health maintenance services among Medicare plan members. Data were from 110 238 elderly completing the 2006 Medicare Health Outcomes Survey. Receipt of recommended patient-physician communication and interventions for urinary incontinence, physical activity, falls, and osteoporosis was modeled as a function of risk factors. Low education decreased the odds of receiving services; poor health increased odds. Race had little effect. Evidence suggested moderation among competing effects. While clinicians target services to most at-risk elderly individuals, patients with low education experience gaps. Synergies among co-occurring risks warrant further research.