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The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries.
Health Serv Res. 2005 Apr; 40(2):517-37.HS

Abstract

OBJECTIVE

To explore three potential causes of racial/ethnic differences in influenza vaccination rates in the elderly: (1) resistant attitudes and beliefs regarding vaccination by African-American and Hispanic Medicare beneficiaries, (2) poor access to care during influenza vaccination weeks, and (3) discriminatory behavior by providers.

DATA SOURCES

Medicare beneficiaries who responded to both the 1995 and 1996 Medicare Current Beneficiary Survey (MCBS) (n=6,746).

STUDY DESIGN

We combined survey information from the MCBS with Medicare claims. We measured resistance to vaccination by self-reported reasons for not receiving vaccination, access to care by claims submitted during vaccination weeks, and discrimination by racial differences in vaccinations among beneficiaries who visited the same providers during vaccination weeks.

PRINCIPAL FINDINGS

White beneficiaries (66.6 percent) were more likely to self-report having received vaccination than were African Americans (43.3 percent) or Hispanics (52.5 percent). Resistance to vaccination plays a role in low vaccination rates of African-American (-11.8 percentage points), but not Hispanic beneficiaries. Unequal access accounts for <2 percent of the disparity. Minority beneficiaries remained unvaccinated despite having medical encounters with their usual providers on days when those same providers were administering vaccinations to white beneficiaries. This disparity is attributable not to provider discrimination but to a 1.6-5 x higher likelihood of white beneficiaries initiating encounters for the purpose of receiving vaccination.

CONCLUSION

Disparities in access to care and provider discrimination play little role in explaining racial/ethnic disparities in influenza vaccination. Eliminating missed opportunities for vaccination in 1995 would have raised vaccination rates in three racial/ethnic groups to the Healthy People 2000 goal of 60 percent vaccination.

Authors+Show Affiliations

Mount Sinai School of Medicine, Department of Health Policy, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15762905

Citation

Hebert, Paul L., et al. "The Causes of Racial and Ethnic Differences in Influenza Vaccination Rates Among Elderly Medicare Beneficiaries." Health Services Research, vol. 40, no. 2, 2005, pp. 517-37.
Hebert PL, Frick KD, Kane RL, et al. The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries. Health Serv Res. 2005;40(2):517-37.
Hebert, P. L., Frick, K. D., Kane, R. L., & McBean, A. M. (2005). The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries. Health Services Research, 40(2), 517-37.
Hebert PL, et al. The Causes of Racial and Ethnic Differences in Influenza Vaccination Rates Among Elderly Medicare Beneficiaries. Health Serv Res. 2005;40(2):517-37. PubMed PMID: 15762905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries. AU - Hebert,Paul L, AU - Frick,Kevin D, AU - Kane,Robert L, AU - McBean,A Marshall, PY - 2005/3/15/pubmed PY - 2005/5/27/medline PY - 2005/3/15/entrez SP - 517 EP - 37 JF - Health services research JO - Health Serv Res VL - 40 IS - 2 N2 - OBJECTIVE: To explore three potential causes of racial/ethnic differences in influenza vaccination rates in the elderly: (1) resistant attitudes and beliefs regarding vaccination by African-American and Hispanic Medicare beneficiaries, (2) poor access to care during influenza vaccination weeks, and (3) discriminatory behavior by providers. DATA SOURCES: Medicare beneficiaries who responded to both the 1995 and 1996 Medicare Current Beneficiary Survey (MCBS) (n=6,746). STUDY DESIGN: We combined survey information from the MCBS with Medicare claims. We measured resistance to vaccination by self-reported reasons for not receiving vaccination, access to care by claims submitted during vaccination weeks, and discrimination by racial differences in vaccinations among beneficiaries who visited the same providers during vaccination weeks. PRINCIPAL FINDINGS: White beneficiaries (66.6 percent) were more likely to self-report having received vaccination than were African Americans (43.3 percent) or Hispanics (52.5 percent). Resistance to vaccination plays a role in low vaccination rates of African-American (-11.8 percentage points), but not Hispanic beneficiaries. Unequal access accounts for <2 percent of the disparity. Minority beneficiaries remained unvaccinated despite having medical encounters with their usual providers on days when those same providers were administering vaccinations to white beneficiaries. This disparity is attributable not to provider discrimination but to a 1.6-5 x higher likelihood of white beneficiaries initiating encounters for the purpose of receiving vaccination. CONCLUSION: Disparities in access to care and provider discrimination play little role in explaining racial/ethnic disparities in influenza vaccination. Eliminating missed opportunities for vaccination in 1995 would have raised vaccination rates in three racial/ethnic groups to the Healthy People 2000 goal of 60 percent vaccination. SN - 0017-9124 UR - https://www.unboundmedicine.com/medline/citation/15762905/The_causes_of_racial_and_ethnic_differences_in_influenza_vaccination_rates_among_elderly_Medicare_beneficiaries_ L2 - https://doi.org/10.1111/j.1475-6773.2005.00370.x DB - PRIME DP - Unbound Medicine ER -