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. 2017 Jun 1;36(6):1065-1069.
doi: 10.1377/hlthaff.2016.1416.

For Selected Services, Blacks And Hispanics More Likely To Receive Low-Value Care Than Whites

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For Selected Services, Blacks And Hispanics More Likely To Receive Low-Value Care Than Whites

William L Schpero et al. Health Aff (Millwood). .
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Abstract

US minority populations receive fewer effective health services than whites. Using Medicare administrative data for 2006-11, we found no consistent, corresponding protection against the receipt of ineffective health services. Compared with whites, blacks and Hispanics were often more likely to receive the low-value services studied.

Keywords: Disparities; Health Reform; Medicare; Minority Health; Quality Of Care.

Figures

Exhibit 1
Exhibit 1
Unadjusted racial and ethnic differences in receipt of low-value care among Medicare beneficiaries, 2006–11 Sources/Notes: SOURCES Authors’ analysis of 2006–11 Medicare administrative data. NOTES Odds ratios showing the relative receipt of low-value services for black vs. white beneficiaries and Hispanic vs. white beneficiaries. 95% confidence interval indicated with bands. BPH is benign prostatic hypertrophy. DXA is dual-energy x-ray absorptiometry.
Exhibit 4
Exhibit 4
Adjusted racial and ethnic differences in receipt of low-value care among Medicare beneficiaries, 2006–11 Sources/Notes: SOURCES Authors’ analysis of 2006–11 Medicare administrative data and 2006–10 American Community Survey data. NOTES Odds ratios showing the relative receipt of low-value services for black vs. white beneficiaries and Hispanic vs. white beneficiaries. All odds ratios have been adjusted using logistic regression for individual-level characteristics, including age, income, sex, disability status, Medicaid enrollment, risk score, log of number of outpatient clinician visits, percent of outpatient visits to primary care, and fixed effects for a given beneficiary’s hospital referral region and year. 95% confidence interval indicated with bands. BPH is benign prostatic hypertrophy. DXA is dual-energy x-ray absorptiometry.
Exhibit 5
Exhibit 5
Adjusted racial and ethnic differences in the association between outpatient clinician visits and receipt of low-value care among Medicare Beneficiaries, 2006–11 Sources/Notes: SOURCES Authors’ analysis of 2006–11 Medicare administrative data and 2006–10 American Community Survey data. NOTES Ratio of odds ratios showing the relative receipt of low-value services for black vs. white beneficiaries and Hispanic vs. white beneficiaries given a one-point increase in the log of the number of outpatient visits (exponentiated coefficient on the interaction between the race and health care utilization variables). All results have been adjusted using logistic regression for individual-level characteristics, including age, income, sex, disability status, Medicaid enrollment, risk score, log of number of outpatient clinician visits, percent of outpatient visits to primary care, and fixed effects for a given beneficiary’s hospital referral region and year. 95% confidence interval indicated with bands. BPH is benign prostatic hypertrophy. DXA is dual-energy x-ray absorptiometry.

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