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Cited by 403Healthcare Policy and ManagementHealth disparities and outcomesChronic Disease Management Strategies

Comparing kaiser Permanente members to the general population: implications for generalizability of research

Open access
Davis, Anna C, Voelkel, Jackson L, Remmers, Carol L, Adams, John L, McGlynn, Elizabeth A·2023·The Permanente Journal
DOI 10.7812/tpp/22.172PMC PMC10266863
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Abstract

Introduction Insight into the characteristics of populations from which research samples are drawn is essential to understanding the generalizability of research findings. This study characterizes the membership of Kaiser Permanente and compares members to the population of the communities in which they live. Methods This study is a descriptive comparison of population distributions for Kaiser Permanente members vs the general population within counties in which Kaiser Permanente operates. Kaiser Permanente data on demographics, membership, geographically linked census data, and chronic condition prevalence were compared with community data drawn from the US Census and the Behavioral Risk Factor Surveillance System. Results Overall, Kaiser Permanente members were older (50% aged 40 or older compared to 45.8% of the general population) and more likely to be female (51.8% vs 50.5% of the general population). Distribution by race and ethnicity was similar for all Regions combined but varied somewhat within Regions. Distribution by neighborhood-linked income, education, and social vulnerability was similar between Kaiser Permanente and the community. Prevalence of 6 of 7 chronic conditions was higher in the community than in Kaiser Permanente, with differences ranging from 0.5% for depression to 7.7% for hyperlipidemia. Conclusion The demographic characteristics of Kaiser Permanente members are similar to the general population within each of the Kaiser Permanente Regions. Overall, the size and diversity of the Kaiser Permanente membership offers an effective platform for research. This approach to comparing health system members with the larger community provides valuable context for interpreting real-world evidence, including understanding the generalizability of research and of measures of system performance.

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  • The findings of this study may not generalize to the broader US population, particularly to the uninsured or underinsured population, or those living in the southern states.

    “Sixth, this data came from six integrated healthcare systems that are broadly representative of the regions they serve in terms of age, race and ethnicity, and sex distribution, nevertheless, the findings of this study may not generalize to the broader US population, particularly to the uninsured or underinsured population, or those living in the southern states.27”

    From Race and ethnicity and pharmacy dispensing of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes (2024) · cites this paper as [27]

    The Discussion says Kaiser Permanente findings might generalize to the local areas served, while the Limitations note that patients in integrated health systems may have different access to care than patients elsewhere. The paper also distinguishes its fully insured members from uninsured people in the general population. These passages support caution about generalizing to uninsured people, but they do not specifically establish a limitation for underinsured people or residents of southern states. (LLM, conf=0.82)

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Research works printed but not linked: 2

  1. [20]Cook RD, Weisberg S. Applied Regression Including Computing and Graphics. New York, NY, USA: John Wiley & Sons; 2009.
  2. [21]Greenland S. Applications of stratified analysis methods. In: Rothman KJ, Greenland S, Lash TL, eds. Modern Epidemiology. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008: 283– 302.

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Authors
Davis, A. C., Voelkel, J. L., Remmers, C. L., Adams, J. L., & McGlynn, E. A.
Affiliations
Kaiser Permanente (US)
Corresponding author
McGlynn, Elizabeth A
ORCID
Venue
The Permanente Journal
Publisher
The Permanente Federation
Published
2023-06-15
Volume
27
Issue
2
Pages
87-98
ISSN
  • 1552-5767 (ISSN-L)
  • 1552-5775
DOI
10.7812/tpp/22.172
PMC
PMC10266863
OpenAlex
W4376226427
Cited by
402
References
15
Citations by year
2026: 110 · 2025: 165 · 2024: 101 · 2023: 26
FWCI
81.86
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • The Permanente Journal (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
Kaiser Permanente
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
Kaiser Permanente, generalizability of research, population representativeness, demographic factors, chronic disease prevalence, health disparities, social vulnerability, real-world evidence
MeSH terms
California, Educational Status, Female, Humans, Income, Male, Residence Characteristics, Censuses

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