Medicare treatment differences for blacks and whites.
OBJECTIVE
This study investigated racial differences in procedure use among elderly Medicare beneficiaries. It is hypothesized that providers do not discriminate inappropriately in treating black and white patients and that the apparent differences in black-white treatment could be attributed to other differences between the two populations.


METHODS
Rates of use for selected procedures were examined among two patient groups: (1) the universe of Medicare beneficiaries in 10 states and the District of Columbia and (2) a subset of this sample created by matching beneficiaries on the basis of zip code of residence to neutralize the effects of black-white differences in provider access and regional practice patterns. Because all Medicare beneficiaries have a common core of standard benefits, the importance of financial access differences in accounting for black/white utilization differences is diminished.


RESULTS
Three major findings were indicated from this study: (1) area-controlled comparisons find even larger black-white disparities than those shown from uncontrolled comparisons, (2) the disparities are larger in southern states, and (3) the disparities vary substantially with procedure cost.


CONCLUSIONS
Although no clinical data were analyzed, providers appeared to be giving less intensive treatment to otherwise similar black Medicare beneficiaries.
Lee
A J
AJ
Center for Health Economics Research, Waltham, MA 02154 USA.
Gehlbach
S
S
Hosmer
Reti
M
M
Baker
C S
CS
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data*; D011287:Prejudice; D012494:Sampling Studies; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000706:statistics & numerical data*