Racial Disparities in Avoidable Hospitalizations in Traditional Medicare and Medicare Advantage.
Journal
Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
pubmed:
26
8
2021
medline:
17
11
2021
entrez:
25
8
2021
Statut:
ppublish
Résumé
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. 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. 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). 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. Our findings provide evidence of racial disparities in access to high-quality primary care, especially in MA.
Identifiants
pubmed: 34432767
doi: 10.1097/MLR.0000000000001632
pii: 00005650-202111000-00007
pmc: PMC8519483
mid: NIHMS1730526
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
989-996Subventions
Organisme : NIA NIH HHS
ID : P30 AG012836
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG057501
Pays : United States
Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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