Minority Health Archive

Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care

Schneider, Eric C. and Zaslavsky, Alan M. and Epstein, Arnold M. (2002) Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care. JAMA, 287 (10). pp. 1288-1294.

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Abstract

Context Substantial racial disparities in the use of some health services exist; however, much less is known about racial disparities in the quality of care. Objective To assess racial disparities in the quality of care for enrollees in Medicare managed care health plans. Design and Setting Observational study, using the 1998 Health Plan Employer Data and Information Set (HEDIS), which summarized performance in calendar year 1997 for 4 measures of quality of care (breast cancer screening, eye examinations for patients with diabetes, -blocker use after myocardial infarction, and follow-up after hospitalization for mental illness). Participants A total of 305 574 (7.7%) beneficiaries who were enrolled in Medicare managed care health plans had data for at least 1 of the 4 HEDIS measures and were aged 65 years or older. Main Outcome Measures Rates of breast cancer screening, eye examinations for patients with diabetes, -blocker use after myocardial infarction, and follow-up after hospitalization for mental illness. Results Blacks were less likely than whites to receive breast cancer screening (62.9% vs 70.9%; P<.001), eye examinations for patients with diabetes (43.6% vs 50.4%; P = .02), -blocker medication after myocardial infarction (64.1% vs 73.8%; P<.005), and follow-up after hospitalization for mental illness (33.2 vs 54.0%; P<.001). After adjustment for potential confounding factors, racial disparities were still statistically significant for eye examinations for patients with diabetes, -blocker use after myocardial infarction, and follow-up after hospitalization for mental illness. Conclusion Among Medicare beneficiaries enrolled in managed care health plans, blacks received poorer quality of care than whites.


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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: racial disparities; quality of care; Medicare; managed care health plans
Subjects: Health > Health Equity > Access To Healthcare
Health > Disparities
Research
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Depositing User: Users 141 not found.
Date Deposited: 05 Dec 2008
Last Modified: 07 Jul 2011 14:51
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/1160

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