title: The effect modification of supplemental insurance on the relationship between race and bone mineral density screening in female Medicare beneficiaries.
abstract: To determine the effect modification of supplemental insurance on the relationship between race and bone mineral density (BMD) in female Medicare beneficiaries. Retrospectively analyzing hospital administrative claim and clinical data of female Medicare beneficiaries (n = 1,398), we performed multivariate logistic regressions of BMD testing including data from all study participants and the subsets of health insurance. Significantly fewer Black than White female Medicare beneficiaries received the BMD testing in the overall sample (odds ratio, OR = 0.63; p = 0.02) and those without supplementary health insurance (n = 709; OR = 0.38; p = 0.004). By contrast, the magnitude of this racial disparity in the BMD testing was diminished among those with supplementary private health insurance (n = 689). We found a significant racial disparity in BMD testing for Black and White female Medicare beneficiaries. This disparity became more pronounced among those without supplementary private health insurance.
authors.affiliation: Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA. yoojiw@trinity-health.org
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yoo
authors.forename: Shunichi
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Sulgi
authors.initials: S
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D015519:Bone Density; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D010024:Osteoporosis / Q000175:diagnosis; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American