Journal article
Racial and Ethnic Disparities in Hospital-Based Care Among Dual Eligibles Who Use Health Centers
Health equity, Vol.7(1), pp.9-18
01/01/2023
DOI: 10.1089/heq.2022.0037
PMCID: PMC9892926
PMID: 36744239
Abstract
ethnic disparities in this population have not been widely studied. We examined the extent of racial and ethnic disparities in hospital-based care among duals using health centers and the degree to which disparities occur within or between health centers.
Methods: We used 2012–2018 Medicare claims and health center data to model emergency department (ED) visits, observation stays, hospitalizations, and 30-day unplanned returns as a function of race and ethnicity among dual eligibles using health centers.
Results: In rural and urban counties, age-eligible Black individuals had more ED visits (7.9 [4.0, 11.7] and 13.7 [10.0, 17.4] per 100 person-years) and were more likely to experience an unplanned return (1.4 [0.4, 2.4] and 1 [0.4, 1.6] percentage points [pp]) than White individuals, but were less likely to be hospitalized (−3.3 [−3.9, −2.8] and −1.2 [−1.6, −0.9] pp). In urban counties, age-eligible Black individuals were 1.2 [0.9, 1.5] pp more likely than White individuals to have observation stays. Other racial and ethnic groups used the same or less hospital-based care than White individuals. Including state and health center fixed effects eliminated Black versus White disparities in all outcomes, except hospitalization. Results were similar among disability–eligible duals.
Conclusion: Racial and ethnic disparities in hospital-based care among dual eligibles are less common within than between health centers. If health centers are to play a more central role in eliminating racial and ethnic health disparities, these differences across health centers must be understood and addressed.
Details
- Title: Subtitle
- Racial and Ethnic Disparities in Hospital-Based Care Among Dual Eligibles Who Use Health Centers
- Creators
- Brad Wright - University of North Carolina at Chapel HillJill Akiyama - University of North Carolina at Chapel HillAndrew J. Potter - California State University, ChicoLindsay M. Sabik - University of PittsburghGrace G. Stehlin - University of North Carolina at Chapel HillAmal N. Trivedi - Brown UniversityFredric D. Wolinsky - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health equity, Vol.7(1), pp.9-18
- DOI
- 10.1089/heq.2022.0037
- PMID
- 36744239
- PMCID
- PMC9892926
- NLM abbreviation
- Health Equity
- ISSN
- 2473-1242
- eISSN
- 2473-1242
- Language
- English
- Date published
- 01/01/2023
- Academic Unit
- Health Management and Policy; Public Policy Center (Archive)
- Record Identifier
- 9984364527602771
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