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

• Published in: JAMA : the journal of the American Medical Association 2002-03, Vol.287 (10), p.1288-1294
• Main Authors: Schneider, Eric C, Zaslavsky, Alan M, Epstein, Arnold M
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; African Americans; African Americans - statistics & numerical data; Aged; Bioethics; Biological and medical sciences; Breast Neoplasms - prevention & control; Diabetic Retinopathy - prevention & control; European Continental Ancestry Group - statistics & numerical data; Female; Health care delivery; Health Services Accessibility; Health Services for the Aged - standards; Health Services for the Aged - statistics & numerical data; Hispanic Americans - statistics & numerical data; Humans; Male; Managed care; Managed Care Programs - standards; Managed Care Programs - statistics & numerical data; Mass Screening - statistics & numerical data; Medical sciences; Medicare; Medicare Part C - standards; Mental Disorders - rehabilitation; Myocardial Infarction - drug therapy; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality Indicators, Health Care; Quality of service; Racial discrimination; Socioeconomic Factors; Specific populations (family, woman, child, elderly...); United States - epidemiology; White people
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.287.10.1288

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, β-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, β-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