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Health Care Disparities in Disadvantaged Medicare Beneficiaries: A National Project Review

JHHSA, Vol. 26 No. 2, (2003)

The wealth of literature documenting differences in health care
utilization by race and ethnicity underscores the need to develop a
system to effectively measure health care related disparities. The
Centers for Medicare & Medicaid Services has taken the first steps
toward detailing the quality of care for fee-for-service (FFS) Medicare
beneficiaries. Using data collected for the two-period 1997-1999 on a
cross-section of beneficiaries from all states and territories of the U.S.,
quality was measured using a set of 24 indicators of care. The results of
this effort were reported in the October 4, 2000 issue of the Journal of
the American Medical Association. This article reports similar
measures of quality but focuses specifically on disparities in the
indicators among five disadvantaged Medicare beneficiary groups:
African-American, American Indian/Alaska Natives, Asian/Pacific
Islanders, Hispanics, and Medicare beneficiaries enrolled in Medicaid
(dually enrolled). These indicators serve as a baseline for tracking
quality improvement within disadvantaged populations and evaluating
the success of efforts to reduce health care disparities at the national
The findings suggest that patterns of disparities exist in both the
inpatient and outpatient settings for disadvantaged beneficiaries. Over
the next decade, the composition of Medicare beneficiaries will become
more diverse. This increasing diversity makes it imperative to identify
and monitor the existence and extent of health care disparities. The
consistent and ongoing evaluation of racial, ethnic, and socioeconomic disparities should provide an incentive to create effective preventive
programs tailored to specific community needs.

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