Racial/Ethnic Disparities in Health Care, Outcomes Examined

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Racial/Ethnic Disparities in Health Care, Outcomes Examined
Racial/Ethnic Disparities in Health Care, Outcomes Examined

(HealthDay News) — Racial and ethnic disparities exist among Medicare Advantage Plan enrollees, and improved performance on quality measures is accompanied by increased racial/ethnic equity, according to two studies published in the New England Journal of Medicine.

John Z. Ayanian, MD, MPP, from the University of Michigan Medical School in Ann Arbor, and colleagues compared the age- and sex-adjusted proportions of elderly enrollees in Medicare Advantage health plans with adequate control of blood pressure (BP), cholesterol and glycated hemoglobin. 

The researchers found that in 2006 and 2011, black enrollees were less likely to have adequate control of BP, cholesterol and glycated hemoglobin than white enrollees (P<.001); in 2011, Hispanic enrollees were also less likely to have adequate control (P≤.02 for all comparisons).

Amal N. Trivedi, MD, MPH, from the Providence Veterans Affairs Medical Center in Rhode Island, and colleagues assessed performance rates for quality measures covering acute myocardial infarction (MI), heart failure and pneumonia among non-Hispanic white, non-Hispanic black, and Hispanic patients. 

The researchers found that between 2005 and 2010, there was a 3.4% improvement in adjusted performance rates for the 17 quality measures (P<.001 for all comparisons). In 2005, adjusted performance rates were more than 5% lower for black and Hispanic patients on three and six measures, respectively, compared with white patients; these gaps decreased significantly between 2005 and 2010.

"Our study provides support for the notion that efforts to improve the overall quality of care may also reduce racial and ethnic disparities," Trivedi and colleagues wrote.

In an accompanying editorial, Marshall H. Chin, MD, MPH, of University of Chicago Medicine, said the "good news" is that researchers and clinicians know more about how to reduce health care disparities but also stressed that more can be done to improve outcomes among racial/ethnic minorities. 

"Leadership matters. It is our professional responsibility as clinicians, administrators, and policymakers to improve the way we deliver care to diverse patients, including patients of any racial or ethnic background. We can do better," Dr. Chin wrote.

References

  1. Ayanian JZ et al. N Engl J Med. 2014;371:2288-2297.
  2. Trivedi AN et al. N Engl J Med. 2014;371:2298-2308.
  3. Chin MH. N Engl J Med. 2014;doi:371:2331-2332.
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