title: Preventable hospitalization and medicaid managed care: does race matter?
abstract: This study examines the preventable hospitalization patterns of Medicaid patients by race/ethnicity to determine whether Medicaid managed care (MMC) has been more effective in some subgroups than others. It uses logistic models for three states, comparing preventable hospitalizations with marker admissions (urgent admissions, insensitive to primary care). Hospital discharge data from the Healthcare Cost and Utilization Project State Inpatient database of the Agency for Health Care Research and Quality for New York, Pennsylvania, and Wisconsin residents aged 20-64 years is used. In a more urban state, New York, MMC was effective for Whites but not for minorities. In a more rural state, Wisconsin, MMC was effective for minorities. Overall, the evidence is not strong that any particular racial group consistently benefited from MMC, or that any state consistently showed a favorable impact of MMC across racial groups. However, racial/ethnic disparity associated with the risk of preventable hospitalization is significantly lower among Medicaid patients than among private fee-for-service patients.
authors.affiliation: Agency for Healthcare Research and Quality, USA. Jbasu@ahrq.gov
authors.forename: Jayasree
authors.initials: J
authors.lastname: Basu
authors.forename: Bernard
authors.initials: B
authors.lastname: Friedman
authors.forename: Helen
authors.initials: H
authors.lastname: Burstin
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008329:Managed Care Programs; D008484:Medicaid / Q000458:organization & administration*; D008875:Middle Aged; D015999:Multivariate Analysis; D009518:New York; D010414:Pennsylvania; D011314:Preventive Health Services; D044465:White People / Q000706:statistics & numerical data; D014922:Wisconsin; D001741:Black or African American