Racial and Ethnic Disparities Vary With Level of Health

The magnitude of racial and ethnic disparities varies with patients’ health status, according to a new AHRQ study. AHRQ staff researchers used 2010–2014 data from the agency’s Medical Expenditure Panel Survey to determine the relationship between health status and the magnitude of black–white and Hispanic–white disparities in the use of office-based or hospital outpatient care. They found that the Hispanic–white differences in the likelihood of having any visit were largest among adults in excellent health (27 percentage points) and narrowest when reporting poor or fair health (15 percentage points). In contrast, among the privately insured, they found wider disparities in the number of office visits for those reporting poor or fair health. Access the abstract of the study published in Health Services Research.

2018 Nov 14. doi: 10.1111/1475-6773.13087. [Epub ahead of print]

Do racial and ethnic disparities in health care use vary with health?

Biener AI1, Zuvekas SH2.

Author information

Abstract

OBJECTIVE:

To determine the relationship between health status and the magnitude of black-white and Hispanic-white disparities in the likelihood of having any office-based or hospital outpatient department visits, as well as number of visits.

DATA SOURCE:

2010-2014 Medical Expenditure Panel Survey.

STUDY DESIGN:

The probability of having a visit is modeled using a Probit model, and the number of visits using a negative binomial model. We use a nonlinear rank-and-replace method to adjust minority health status to be comparable to that of whites, and predict utilization at different levels of health by fixing an indicator of health status. We compare estimated differences in predicted utilization across racial/ethnic groups for each level of health status to map out the relationship between the racial/ethnic disparity and health status, also stratifying by health insurance coverage.

EXTRACTION METHODS:

We subset to nonelderly adults.

PRINCIPAL FINDINGS:

We find that Hispanic-white differences in the probability of having an office-based or hospital outpatient department were widest among adults in excellent health (27 percentage points, 95% CI: [23, 31]) and narrowest when reporting poor or fair health (15 p.p. [13, 17]). Black-white and Hispanic-white differences in the number of visits were wider for adults who report poor or fair health (5.3 visits [4.0, 6.6] and 5.7 [4.3, 7.0], respectively) compared to excellent health (1.7 [1.2, 2.1] and 1.5 [1.1, 2.0], respectively) among adults who are full-year privately insured.