Racial Disparities in Avoidable Hospitalizations in Traditional Medicare and Medicare Advantage
Bibliographic Data
| ID | 9101490 |
|---|---|
| Authors | Sungchul Park (0000-0002-7546-9685, Drexel University, corresponding author), Paul Fishman (0000-0003-3419-4539, University of Washington), Norma B Coe (0000-0003-1228-0938, Department of Medical Ethics and Health Policy, Perelman School of Medicine) |
| Year | 2021 |
| Volume | 59 |
| Issue | 11 |
| Pages | 989-996 |
| Publication date | 2021-11-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001632 |
| PMID | 34432767 |
| OpenAlex | W3196001024 |
| Language | EN |
| Citations received | 3 |
| References cited | 29 |
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
Ambulatory · Confidence interval · Effect modification · Ethnic group · Family medicine · Health care · Health equity · Health insurance · Propensity score matching · Public health · Racial differences · Referral · Chronic Disease Management Strategies · Demography · Healthcare Policy and Management · Internal Medicine · Medicine · Primary Care and Health Outcomes · Gerontology
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| Citations per year | 0.75 |
|---|---|
| Citation span | 2022 - 2025 (4) |
| Highly cited | No |