title: Do managed care plans reduce racial disparities in preventive care?
abstract: This study was designed to determine whether managed care plans reduce racial disparities in use of influenza vaccination, mammography, and prostate-specific antigen screening. The study analyzed the use of three types of preventive care in a population-based sample of adults who were 65 years or older and were enrolled in a Medicare managed care (MMC) or fee-for-service (FFS) plan in Allegheny County, Pennsylvania. The study sample included 463 African Americans and 592 whites. Fewer African Americans than whites reported having had an influenza vaccination (64.4% versus 76.5%; p < 0.01) or a prostate-specific antigen test (64% versus 71.2%; p = 0.09) during the previous year. Slightly more African Americans than white women reported having had a mammogram (66.1% versus 63.8%). Logistic regression showed that, regardless of health plan type, African Americans were significantly less likely than whites to have an influenza vaccination (p < 0.05). A MMC plan did not narrow racial differences in preventive care. Reducing disparities may require interventions developed for specific racial/ethnic groups.
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh, USA. cjlin@pitt.edu
authors.forename: Chyongchiou Jeng
authors.initials: CJ
authors.lastname: Lin
authors.forename: Donald
authors.initials: D
authors.lastname: Musa
authors.forename: Myrna
authors.initials: M
authors.lastname: Silverman
authors.forename: Howard B
authors.initials: HB
authors.lastname: Degenholtz
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D008137:Longitudinal Studies; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid; D008875:Middle Aged; D010414:Pennsylvania; D011314:Preventive Health Services / Q000458:organization & administration*; D017430:Prostate-Specific Antigen / Q000032:analysis; D012935:Social Justice; D014481:United States
chemical_list: D007252:Influenza Vaccines; D017430:Prostate-Specific Antigen