Research Objective: Using preventable hospitalizations (PHs) as a measure of poor access to care, two studies report conflicting findings about association between race and PHs in the Medicare population. We examine whether rates of PHs vary across Medicare beneficiaries by race or Hispanic origin. Study Design: Using 1996 hospital discharge data from 10 states: AZ, CA, FL, MA, MO, NJ, NY, PA, SC, and VA, we identified all hospitalizations of Medicare beneficiaries age 65 and older excluding those hospitalized for a mental disorder. For each state, we calculated unadjusted rates of PHs and estimated logistic regression models predicting whether a Medicare patient was hospitalized for a preventable condition or another reason controlling for confounding factors. Principal findings: Unadjusted PH rates were higher for Black and Hispanic Medicare patients relative to White Medicare patients in 10 states and 8 states, respectively. After adjusting for confounding factors, the odds of Black Medicare patients being admitted for a PH were significantly greater than White Medicare patients in 8 states and Hispanic Medicare patients had higher rates of PH in 6 states. The odds ratios ranged from 1.06-1.3. Conclusions: While Medicare coverage improves access to care for the elderly it does not eliminate the disparities across racial and ethnic groups. Other factors that affect access need examination by both researchers and policymakers - including the competency of providers, supplemental insurance plans, and personal health-seeking behavior.
Learning Objectives: During this session participants will learn: 1) how rates of preventable hospitalizations (PH) vary across states; 2) how rates of PHs vary by race and ethnic; 3) what factors affect rates of PHs
Keywords: Medicare, Barriers to Care
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.