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Changes in racial differences in use of medical procedures and diagnostic tests among elderly persons: 1986-1997
José J Escarce1, Thomas G McGuire
1Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02115, USA.
Objectives:
We used 1997 Medicare data to replicate an earlier study that used data from 1986 to examine racial differences in usage of specific medical procedures or tests among elderly persons.
Methods:
We used 1997 physician claims data to obtain a random sample of 5% of Medicare beneficiaries aged 65 years and older. We used this sample to study 30 procedures and tests that were analyzed in the 1986 study, as well as several new procedures that became more widely used in the early 1990s.
Results:
Racial differences remain in the rates of use of these procedures; in general, Blacks have lower rates of use than do Whites. Between 1986 and 1997, the ratio of White to Black use moved in favor of Blacks for all but 4 of the established procedures studied.
Conclusions:
The White-Black gap in health care use under Medicare is narrowing.
Insights
Racial disparities in medical procedure use among Medicare beneficiaries are narrowing. While Black Medicare beneficiaries still use fewer procedures than White beneficiaries, the gap has decreased since 1986.
Area of Science:
- Health Services Research
- Medical Economics
- Geriatric Medicine
Background:
- Racial disparities in healthcare access and utilization persist among elderly populations.
- Previous studies in 1986 highlighted significant differences in the use of medical procedures between White and Black Medicare beneficiaries.
- Understanding trends in healthcare utilization is crucial for addressing health inequities.
Purpose of the Study:
- To replicate a 1986 study examining racial differences in medical procedure usage among elderly Medicare beneficiaries.
- To assess changes in these racial disparities using updated 1997 Medicare data.
- To evaluate the utilization of both established and newly prevalent medical procedures.
Main Methods:
- Utilized 1997 Medicare physician claims data for a random 5% sample of beneficiaries aged 65 and older.
- Analyzed the usage of 30 procedures and tests previously studied in 1986.
- Included several new procedures that gained prominence in the early 1990s.
Main Results:
- Racial differences in the rates of medical procedure and test utilization among Medicare beneficiaries persist.
- Black beneficiaries generally exhibited lower utilization rates compared to White beneficiaries.
- Between 1986 and 1997, the ratio of White to Black utilization shifted favorably for Black beneficiaries across most studied procedures.
Conclusions:
- The gap in healthcare utilization between White and Black Medicare beneficiaries is narrowing.
- Despite improvements, disparities in access to and use of medical services remain a concern.
- Continued monitoring of healthcare utilization patterns is essential for promoting health equity.
