Trends in Racial Disparities in Healthcare Expenditures Among Senior Medicare Fee-for-service Enrollees in 2007-2020.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2024-12-01 Epub Date: 2023-11-13 DOI:10.1007/s40615-023-01832-x

Seo H Baik, Fitsum Baye, Clement J McDonald

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Abstract

Despite the universal healthcare coverages, racial disparities in healthcare expenditures among senior Medicare beneficiaries exist. A few studies explored how racial disparities in healthcare expenditures changed over past decades and how it affected differently across 4 minoritized races, by type of Medicare and poverty levels. We conducted a longitudinal study of 21 healthcare expenditures from senior Medicare fee-for-service enrollees to determine overall and secular trends in racial disparities in healthcare expenditures between 2007 and 2020, during which the Affordable Care Act (ACA) came into full force and the COVID-19 pandemic had begun. We found important disparities in healthcare expenditures across 4 minoritized races compared to Whites, even after adjusting for possible confounders for such disparities. Disparities between Hispanics/Asians and Whites were much greater than disparities between Blacks and Whites, in all Parts A, B, and D expenditures. This reality has not been sufficiently emphasized in the literature. Importantly, Black-White disparities in total Part B expenditure gradually worsened between 2007 and 2020, and Hispanic-White and Asian-White disparities worsened greatly during that time window. Health planners need to focus on these large disparities and develop methods to shrink them.

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2007-2020年老年医疗保险按服务收费参保人医疗支出的种族差异趋势

尽管全民医疗保健覆盖，在老年医疗保险受益人之间的医疗保健支出存在种族差异。一些研究探讨了过去几十年来医疗支出的种族差异是如何变化的，以及按医疗保险类型和贫困水平划分，它对4个少数民族种族的影响是如何不同的。我们对21名老年医疗保险按服务收费参保人的医疗支出进行了纵向研究，以确定2007年至2020年期间医疗支出中种族差异的总体和长期趋势，在此期间，《平价医疗法案》(ACA)全面生效，COVID-19大流行开始。我们发现，与白人相比，4个少数族裔在医疗保健支出方面存在重要差异，即使在调整了可能的混杂因素后也是如此。在所有A、B和D部分的支出中，西班牙裔/亚洲人与白人之间的差异远远大于黑人与白人之间的差异。这一现实在文献中没有得到充分的强调。重要的是，在2007年至2020年期间，黑人-白人在B部分总支出中的差异逐渐恶化，西班牙裔-白人和亚裔-白人的差异在这段时间内急剧恶化。卫生规划人员需要关注这些巨大的差距，并制定缩小差距的方法。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.