Racial differences in the elderly's use of medical procedures and diagnostic tests.
OBJECTIVE
This study sought to examine racial differences in the use of medical procedures and diagnostic tests by elderly Americans.


METHODS
We used 1986 physician claims data for a 5% national sample of Medicare enrollees aged 65 years and older to study 32 procedures and tests. For each service, we calculated the age- and sex-adjusted rate of use by race and the corresponding White-Black relative risk.


RESULTS
Whites were more likely than Blacks to receive 23 services, and for many of these services, the differences in use were substantial. In contrast, Blacks were more likely than Whites to receive seven services. Whites had a particular advantage in access to higher-technology or newer services. Racial differences in use persisted among elders who had Medicaid in addition to Medicare coverage and increased among rural elders.


CONCLUSIONS
There are pervasive racial differences in the use of medical services by elderly Americans that cannot be explained by differences in the prevalence of specific clinical conditions. Financial barriers to care do not fully account for these findings. Race may exacerbate the impact of other barriers to access.
Escarce
J J
JJ
Department of Medicine, University of Pennsylvania, Philadelphia.
Epstein
K R
KR
Colby
D C
DC
Schwartz
J S
JS
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D016345:Medicare Part B / Q000706:statistics & numerical data*; D012424:Rural Population; D014481:United States; D014505:Urban Population; D044465:White People / Q000706:statistics & numerical data*