Racial disparities in the quality of care for enrollees in medicare managed care
Racial disparities in the quality of care for enrollees in medicare managed care
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DOI：
10.1001/jama.287.10.1288
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发表时间：
2002-03-13
影响因子：
120.7
通讯作者：
Epstein, AM
中科院分区：
文献类型：
--
作者：
Schneider, EC;Zaslavsky, AM;Epstein, AM
背景 在使用某些医疗服务方面存在着巨大的种族差异；然而，人们对护理质量方面的种族差异知之甚少。 目的 评估 Medicare 管理式护理健康计划参与者的护理质量方面的种族差异。 设计和设置观察性研究，使用 1998 年健康计划雇主数据和信息集 (HEDIS)，总结了 1997 日历年 4 项护理质量指标的表现（乳腺癌筛查、糖尿病患者眼科检查、心肌梗死后使用 β 受体阻滞剂）参与者 参加 Medicare 管理式医疗保健计划的总共 305574 名受益人 (7.7%) 拥有 4 项 HEDIS 措施中至少 1 项的数据，且年龄在 65 岁或以上。 主要结果指标 乳腺癌筛查率、糖尿病患者眼部检查率、心肌梗塞后使用 β 受体阻滞剂以及住院后随访率结果黑人接受乳腺癌筛查的可能性低于白人（62.9% vs 70.9%；P
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, beta-blocker use after myocardial infarction, and follow-up after hospitalization for mental illness).Participants A total of 305574 (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, beta-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