Matt T Bagwell1, Thomas T H Wan2. 1. Assistant Professor, Division of Public Administration, School of Criminology, Criminal Justice, and Strategic Studies, College of Liberal and Fine Arts, Tarleton State University, RELLIS Academic Alliance Faculty Member, Texas A&M University System (TAMUS), 1425 Bryan Road, RELLIS ACB1, Room 326, Bryan, TX 77807. 2. Professor, Department of Health Management and Informatics, Doctoral Program in Public Affairs, College of Community Innovation and Education, University of Central Florida, 528 W. Livingston Street, Suite 401, Orlando, FL 32801.
Abstract
PURPOSE: This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4. METHODOLOGY/APPROACH: A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression. FINDINGS: This study found that dual eligible RHC patients utilized ER services at higher rates than non-dual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively. RESEARCH LIMITATIONS/IMPLICATIONS: Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socio-economic status, and race continue to influence higher rates of ER utilization in CMS Region 4. ORIGINALITY/VALUE: In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.
PURPOSE: This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4. METHODOLOGY/APPROACH: A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression. FINDINGS: This study found that dual eligible RHC patients utilized ER services at higher rates than non-dual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively. RESEARCH LIMITATIONS/IMPLICATIONS: Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socio-economic status, and race continue to influence higher rates of ER utilization in CMS Region 4. ORIGINALITY/VALUE: In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.
Entities:
Keywords:
ER Utilization; Health Disparities; Individual Factors; Medicare; Older Adults; Rural Health
Authors: Howard K Koh; Sarah C Oppenheimer; Sarah B Massin-Short; Karen M Emmons; Alan C Geller; K Viswanath Journal: Am J Public Health Date: 2010-02-10 Impact factor: 9.308