5120.0: Wednesday, November 15, 2000 - 1:45 PM

Abstract #10623

Using Medicare Data to Understand the Use of Immunization Services Among Different Race Groups of Medicare Beneficiaries

Paul Hebert, BA and A. Marshall McBean, MD, MSc. Division of Health Services Research and Policy, University of Minnesota School of Public Health, D355 mayo Memorial Building, Box 97, 420 Delaware St., S.E, Minneapolis, MN 55455, 612-626-4248, hebe0031@tc.umn.edu

Annual influenza immunization is recommended for nearly all persons over the age of 65, but white elderly persons are much more likely to get a flu shot than non-white elderly. This study investigates whether differential access to medical care accounts for these differences. Among all non-white Medicare beneficiaries who participated in the 1996 Medicare Current Beneficiary Survey (MCBS), we identified a cohort of 570 non-white beneficiaries who had an outpatient, medical encounter with their primary source of care during weeks when flu shots were administered (October through mid December). We then identified a cohort of 914 white beneficiaries who were visiting these same physicians or clinics during these same weeks. Claims for flu shot administration during these visits were then totaled for white and non-white beneficiaries. We found that racial difference persisted, even among beneficiaries who were being seen in the same offices during weeks when flu shots were given (non-white/white O.R. .44; p<.001). However, these differences diminished when beneficiary-motivated flu shots were taken into account. Among persons who had a physician encounter during flu shot weeks for some purpose other than the receipt of a flu shot, the odds that non-white beneficiary receives a flu shot is not statistically different from that of white beneficiaries (OR=.80; p=.11). We conclude that non-white beneficiaries are not receiving vaccination despite being in a physician’s office on days when that physician is administering flu shots to white beneficiaries. However, much of this difference is attributable to patient-initiated flu shots among white beneficiaries.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to use Medicare data to 1. measure racial differences in immunization use, and 2. assess the reasons these differences exist

Keywords: Immunizations, Medicare

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA