Measuring racial/ethnic disparities across the distribution of health care expenditures.
Measuring racial/ethnic disparities across the distribution of health care expenditures.
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DOI：
10.1111/j.1475-6773.2009.01004.x
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发表时间：
2009-10
影响因子：
3.4
通讯作者：
Manning WG
中科院分区：
文献类型：
--
作者：
Cook BL;Manning WG
评估黑人-白人和西班牙裔-白人在卫生保健总支出的上分位数中的差异是增加还是减少，这取决于协变量。2001年至2005年医疗支出小组调查中具有全国代表性的非西班牙裔白人、非裔美国人和拉美裔成年人口。我们检查支出分配中未经调整的种族/民族差异。我们使用分位数回归来测量中位数、第75、90和95个分位数的差异，测试医疗保健支出分布以及收入和教育类别之间的差异。我们测试了结果对仅基于健康状况的比较的敏感性，并估计了一个由两部分组成的模型，以确保结果不是由具有大的零质量的极其扭曲的支出分布驱动的。黑人-白人和西班牙裔-白人的差异在支出的高分位数中缩小，但在整个分配过程中，黑人和拉美裔的支出仍然明显低于白人。就大多数教育和收入类别而言，差距处于中位数并呈下降趋势，但即使在教育和收入增加的情况下，差距仍然很大。黑人和拉美裔美国人在高支出水平上得到的医疗服务差异很大，这表明优先考虑改善有严重健康问题的少数群体获得高质量医疗服务的机会。
To assess whether Black-White and Hispanic-White disparities increase or abate in the upper quantiles of total health care expenditure, conditional on covariates. Nationally representative adult population of non-Hispanic Whites, African-Americans, and Hispanics from the 2001 - 2005 Medical Expenditure Panel Surveys. We examine unadjusted racial/ethnic differences across the distribution of expenditures. We apply quantile regression to measure disparities at the median, 75th, 90th, and 95th quantiles, testing for differences over the distribution of health care expenditures and across income and education categories. We test the sensitivity of the results to comparisons based only on health status and estimate a two-part model to ensure that results are not driven by an extremely skewed distribution of expenditures with a large zero mass. Black-White and Hispanic-White disparities diminish in the upper quantiles of expenditure, but expenditures for Blacks and Hispanics remain significantly lower than for Whites throughout the distribution. For most education and income categories, disparities exist at the median and decline, but remain significant even with increased education and income. Blacks and Hispanics receive significantly disparate care at high expenditure levels, suggesting prioritization of improved access to quality care among minorities with critical health issues.
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影响因子：
158.5
作者：
Jha, AK;Fisher, ES;Epstein, AM
通讯作者：
Epstein, AM
影响因子：
3.5
作者：
Manning, WG;Mullahy, J
通讯作者：
Mullahy, J
影响因子：
3
作者：
Blanco, Carlos;Patel, Sapana R.;Olfson, Mark
通讯作者：
Olfson, Mark
影响因子：
12.7
作者：
Ford, E;Newman, J;Deosaransingh, K
通讯作者：
Deosaransingh, K
影响因子：
3.7
作者：
DUAN, N
通讯作者：
DUAN, N