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Variation in participation in health care settings associated with race and ethnicity.
J Gen Intern Med. 2004 Sep; 19(9):931-6.JG

Abstract

OBJECTIVE

To use the ecology model of health care to contrast participation of black, non-Hispanics (blacks); white, non-Hispanics (whites); and Hispanics of any race (Hispanics) in 5 health care settings and determine whether disparities between those individuals exist among places where they receive care.

DESIGN

1996 Medical Expenditure Panel Survey data were used to estimate the number of black, white, and Hispanic people per 1,000 receiving health care in each setting.

SETTING

Physicians' offices, outpatient clinics, hospital emergency departments, hospitals, and people's homes.

MAIN MEASUREMENT

Number of people per 1,000 per month who had at least one contact in a health care setting.

RESULTS

Fewer blacks and Hispanics than whites received care in physicians' offices (154 vs 155 vs 244 per 1,000 per month, respectively) and outpatient clinics (15 vs 12 vs 24 per 1,000 per month, respectively). There were no significant differences in proportions hospitalized or receiving care in emergency departments. Fewer Hispanics than blacks or whites received home health care services (7 vs 14 vs 14 per 1,000 per month, respectively). After controlling for 7 variables, blacks and Hispanics were less likely than whites to receive care in physicians' offices (odds ratio [OR], 0.65, 95% confidence interval [CI], 0.60 to 0.69 for blacks and OR, 0.79, 95% CI, 0.73 to 0.85 for Hispanics), outpatient clinics (OR, 0.73, 95% CI, 0.60 to 0.90 for blacks and OR, 0.71, 95% CI, 0.58 to 0.88 for Hispanics), and hospital emergency departments (OR, 0.80, 95% CI, 0.69 to 0.94 for blacks and OR, 0.80, 95% CI, 0.68 to 0.93 for Hispanics) in a typical month. The groups did not differ in the likelihood of receiving care in the hospital or at home.

CONCLUSIONS

Fewer blacks and Hispanics than whites received health care in physicians' offices, outpatient clinics, and emergency departments in contrast to hospitals and home care. Research and programs aimed at reducing disparities in receipt of care specifically in the outpatient setting may have an important role in the quest to reduce racial and ethnic disparities in health.

Authors+Show Affiliations

Carolyn Downs Family Medical Center, 6726 35th Place South, Seattle, WA 98118, USA. ebbliss@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15333057

Citation

Bliss, Erika B., et al. "Variation in Participation in Health Care Settings Associated With Race and Ethnicity." Journal of General Internal Medicine, vol. 19, no. 9, 2004, pp. 931-6.
Bliss EB, Meyers DS, Phillips RL, et al. Variation in participation in health care settings associated with race and ethnicity. J Gen Intern Med. 2004;19(9):931-6.
Bliss, E. B., Meyers, D. S., Phillips, R. L., Fryer, G. E., Dovey, S. M., & Green, L. A. (2004). Variation in participation in health care settings associated with race and ethnicity. Journal of General Internal Medicine, 19(9), 931-6.
Bliss EB, et al. Variation in Participation in Health Care Settings Associated With Race and Ethnicity. J Gen Intern Med. 2004;19(9):931-6. PubMed PMID: 15333057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variation in participation in health care settings associated with race and ethnicity. AU - Bliss,Erika B, AU - Meyers,David S, AU - Phillips,Robert L,Jr AU - Fryer,George E, AU - Dovey,Susan M, AU - Green,Larry A, PY - 2004/8/31/pubmed PY - 2005/1/5/medline PY - 2004/8/31/entrez SP - 931 EP - 6 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 19 IS - 9 N2 - OBJECTIVE: To use the ecology model of health care to contrast participation of black, non-Hispanics (blacks); white, non-Hispanics (whites); and Hispanics of any race (Hispanics) in 5 health care settings and determine whether disparities between those individuals exist among places where they receive care. DESIGN: 1996 Medical Expenditure Panel Survey data were used to estimate the number of black, white, and Hispanic people per 1,000 receiving health care in each setting. SETTING: Physicians' offices, outpatient clinics, hospital emergency departments, hospitals, and people's homes. MAIN MEASUREMENT: Number of people per 1,000 per month who had at least one contact in a health care setting. RESULTS: Fewer blacks and Hispanics than whites received care in physicians' offices (154 vs 155 vs 244 per 1,000 per month, respectively) and outpatient clinics (15 vs 12 vs 24 per 1,000 per month, respectively). There were no significant differences in proportions hospitalized or receiving care in emergency departments. Fewer Hispanics than blacks or whites received home health care services (7 vs 14 vs 14 per 1,000 per month, respectively). After controlling for 7 variables, blacks and Hispanics were less likely than whites to receive care in physicians' offices (odds ratio [OR], 0.65, 95% confidence interval [CI], 0.60 to 0.69 for blacks and OR, 0.79, 95% CI, 0.73 to 0.85 for Hispanics), outpatient clinics (OR, 0.73, 95% CI, 0.60 to 0.90 for blacks and OR, 0.71, 95% CI, 0.58 to 0.88 for Hispanics), and hospital emergency departments (OR, 0.80, 95% CI, 0.69 to 0.94 for blacks and OR, 0.80, 95% CI, 0.68 to 0.93 for Hispanics) in a typical month. The groups did not differ in the likelihood of receiving care in the hospital or at home. CONCLUSIONS: Fewer blacks and Hispanics than whites received health care in physicians' offices, outpatient clinics, and emergency departments in contrast to hospitals and home care. Research and programs aimed at reducing disparities in receipt of care specifically in the outpatient setting may have an important role in the quest to reduce racial and ethnic disparities in health. SN - 0884-8734 UR - https://www.unboundmedicine.com/medline/citation/15333057/Variation_in_participation_in_health_care_settings_associated_with_race_and_ethnicity_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0884-8734&date=2004&volume=19&issue=9&spage=931 DB - PRIME DP - Unbound Medicine ER -