title: Measuring trends in racial/ ethnic health care disparities.
abstract: Monitoring disparities over time is complicated by the varying disparity definitions applied in the literature. This study used data from the 1996-2005 Medical Expenditure Panel Survey (MEPS) to compare trends in disparities by three definitions of racial/ethnic disparities and to assess the influence of changes in socioeconomic status (SES) among racial/ethnic minorities on disparity trends. This study prefers the Institute of Medicine's (IOM) definition, which adjusts for health status but allows for mediation of racial/ethnic disparities through SES factors. Black-White disparities in having an office-based or outpatient visit and medical expenditure were roughly constant and Hispanic-White disparities increased for office-based or outpatient visits and for medical expenditure between 1996-1997 and 2004-2005. Estimates based on the independent effect of race/ethnicity were the most conservative accounting of disparities and disparity trends, underlining the importance of the role of SES mediation in the study of trends in disparities.
authors.affiliation: Cambridge Health Alliance/Harvard Medical School, Somerville, MA, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lê Cook
authors.forename: Thomas G
authors.initials: TG
authors.lastname: McGuire
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Zuvekas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D005102:Health Expenditures / Q000639:trends; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D044469:Racial Groups / Q000208:ethnology*; D012923:Social Class; D014481:United States; D055815:Young Adult
references.citation: Med Care. 2002 Jan;40(1):52-9
references.pmid: 11748426
references.citation: Am Econ Rev. ;95(2):234-7
references.pmid: 29120591
references.citation: Med Care. 2005 Apr;43(4):320-9
references.pmid: 15778635
references.citation: Am J Public Health. 2004 Oct;94(10):1795-9
references.pmid: 15451752
references.citation: Health Serv Res. 2006 Apr;41(2):xiii-xix
references.pmid: 16584450
references.citation: J Gen Intern Med. 2003 Feb;18(2):146-52
references.pmid: 12542590
references.citation: J Pers Soc Psychol. 1986 Dec;51(6):1173-82
references.pmid: 3806354
references.citation: J Health Econ. 2007 Jan;26(1):101-21
references.pmid: 16893581
references.citation: N Engl J Med. 2005 Aug 18;353(7):683-91
references.pmid: 16107621
references.citation: Health Aff (Millwood). 2003 Mar-Apr;22(2):139-53
references.pmid: 12674417
references.citation: Am J Public Health. 2007 Jan;97(1):76-83
references.pmid: 17138911
references.citation: Am J Public Health. 1993 Jul;83(7):948-54
references.pmid: 8328615
references.citation: Health Serv Outcomes Res Methodol. 2009 Mar 1;9(1):1-21
references.pmid: 20352070
references.citation: Health Serv Res. 2006 Apr;41(2):532-49
references.pmid: 16584463
references.citation: N Engl J Med. 2005 Aug 18;353(7):671-82
references.pmid: 16107620
references.citation: Health Serv Res. 2006 Oct;41(5):1979-2005
references.pmid: 16987312
references.citation: Jt Comm J Qual Patient Saf. 2008 May;34(5):256-65
references.pmid: 18491689
references.citation: J Gen Intern Med. 1997 Jul;12(7):431-8
references.pmid: 9229282
references.citation: Health Serv Res. 2007 Feb;42(1 Pt 1):124-45
references.pmid: 17355585
references.citation: Med Care Res Rev. 2000;57 Suppl 1:36-54
references.pmid: 11092157
references.citation: Health Serv Res. 2003 Jun;38(3):809-29
references.pmid: 12822914
references.citation: Med Care. 2006 May;44(5 Suppl):I64-72
references.pmid: 16625066
references.citation: JAMA. 1999 Dec 22-29;282(24):2313-20
references.pmid: 10612318
references.citation: Biometrics. 1999 Jun;55(2):652-9
references.pmid: 11318229
references.citation: Int J Methods Psychiatr Res. 2004;13(3):141-51
references.pmid: 15297898
references.citation: N Engl J Med. 2005 Aug 18;353(7):692-700
references.pmid: 16107622
references.citation: Health Aff (Millwood). 2005 Mar-Apr;24(2):376-87
references.pmid: 15757921