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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Racial Disparities in Avoidable Hospitalizations in Traditional Medicare and Medicare Advantage
Medical care, v 59(11), pp 989-996
01 Nov 2021
PMID: 34432767
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Importance: Compared with traditional Medicare (TM), Medicare Advantage (MA) has the potential to reduce racial disparities in hospitalizations for ambulatory care sensitive conditions (ACSC). As racial disparities may be partly attributable to unequal treatment based on where people live, this suggests the need of examining geographic variations in racial disparities. Objective: The aim of this study was to examine differences in ACSC hospitalizations between White and Black beneficiaries in TM and MA and examine geographic variations in racial differences in ACSC hospitalizations in TM and MA. Methods: We analyzed the 2015-2016 Medicare Provider Analysis and Review files. We used propensity score matching to account for differences in characteristics between TM and MA beneficiaries. Then, we conducted linear regression and estimated adjusted outcomes for TM and MA beneficiaries by race. Also, we estimated racial differences in adjusted outcomes by insurance and hospital referral region (HRR). Results: While White beneficiaries in TM and MA had similar rates of ACSC hospitalizations (163.7 vs. 162.2/10,000 beneficiaries), Black beneficiaries in MA had higher rates of ACSC hospitalizations than Black beneficiaries in TM (221.2 vs. 209.3/10,000 beneficiaries). However, the racial differences were greater in MA than TM (59.0 vs. 45.6/10,000 beneficiaries). Racial differences in ACSC hospitalizations in MA were prevalent across almost all HRRs. 95.5% of HRRs had higher rates of ACSC hospitalizations among Black beneficiaries than White beneficiaries in MA relative to just 54.2% of HRRs in TM. Conclusion: Our findings provide evidence of racial disparities in access to high-quality primary care, especially in MA.
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Details
- Title
- Racial Disparities in Avoidable Hospitalizations in Traditional Medicare and Medicare Advantage
- Creators
- Sungchul Park - Drexel UniversityPaul Fishman - Department of Health Services, School of Public Health, University of Washington, Seattle, WANorma B. Coe - Department of Medical Ethics and Health Policy, Perelman School of Medicine.
- Publication Details
- Medical care, v 59(11), pp 989-996
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Grant note
- R01AG057501 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA National Institute of Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000706833200007
- Scopus ID
- 2-s2.0-85114337858
- Other Identifier
- 991019167676304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services
- Public, Environmental & Occupational Health