Differences in patient perceptions of integrated care among black, hispanic, and white Medicare beneficiaries

Objective This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities. Data Source Data from Medicare beneficiaries who completed the 2015 Medicare Cur...

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Published inHealth services research Vol. 56; no. 3; pp. 507 - 516
Main Authors Ling, Emilia J., Frean, Molly, So, Jody, Tietschert, Maike, Song, Nancy, Covington, Christian, Bahadurazada, Hassina, Khurana, Sonia, Garcia, Luis, Singer, Sara J.
Format Journal Article
LanguageEnglish
Published United States Health Research and Educational Trust 01.06.2021
Blackwell Publishing Ltd
John Wiley and Sons Inc
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Abstract Objective This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities. Data Source Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year. Study Design We used 4‐point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a “rank and replace” method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression. Data Collection/Extraction Methods Not applicable. Principal Findings We found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self‐care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists’ knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications. Conclusions There exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non‐Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.
AbstractList Data Source: Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year. Data Collection/Extraction Methods: Not applicable.
Objective: This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities. Data Source: Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year. Study Design: We used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a "rank and replace" method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression. Data Collection/Extraction Methods: Not applicable. Principal Findings: We found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self-care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists' knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications. Conclusions: There exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non-Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care. KEYWORDS integrated delivery systems, Medicare, patient assessment/satisfaction, racial/ethnic differences in health and health care
ObjectiveThis study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities.Data SourceData from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.Study DesignWe used 4‐point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a “rank and replace” method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression.Data Collection/Extraction MethodsNot applicable.Principal FindingsWe found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self‐care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists’ knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications.ConclusionsThere exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non‐Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.
This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities. Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year. We used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a "rank and replace" method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression. Not applicable. We found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self-care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists' knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications. There exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non-Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.
Objective This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities. Data Source Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year. Study Design We used 4‐point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a “rank and replace” method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression. Data Collection/Extraction Methods Not applicable. Principal Findings We found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self‐care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists’ knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications. Conclusions There exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non‐Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.
This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities.OBJECTIVEThis study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities.Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.DATA SOURCEData from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.We used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a "rank and replace" method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression.STUDY DESIGNWe used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a "rank and replace" method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression.Not applicable.DATA COLLECTION/EXTRACTION METHODSNot applicable.We found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self-care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists' knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications.PRINCIPAL FINDINGSWe found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self-care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists' knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications.There exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non-Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.CONCLUSIONSThere exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non-Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.
Audience Trade
Author Singer, Sara J.
Khurana, Sonia
Tietschert, Maike
Garcia, Luis
Covington, Christian
Ling, Emilia J.
So, Jody
Bahadurazada, Hassina
Song, Nancy
Frean, Molly
AuthorAffiliation 1 Stanford University School of Medicine Stanford California USA
2 The Wharton School University of Pennsylvania Philadelphia Pennsylvania USA
3 Department of Humanities Yale University New Haven Connecticut USA
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Medicare
integrated delivery systems
patient assessment/satisfaction
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2011; 305
2016; 2
2013; 32
2020
2019
2018
2013; 131
2012; 47
2009; 301
2018; 15
2012; 9
e_1_2_8_28_1
Babitsch B (e_1_2_8_50_1) 2012; 9
e_1_2_8_24_1
e_1_2_8_47_1
e_1_2_8_26_1
e_1_2_8_49_1
e_1_2_8_3_1
e_1_2_8_5_1
e_1_2_8_7_1
e_1_2_8_9_1
e_1_2_8_20_1
e_1_2_8_43_1
e_1_2_8_22_1
e_1_2_8_45_1
e_1_2_8_41_1
e_1_2_8_60_1
e_1_2_8_17_1
e_1_2_8_19_1
e_1_2_8_13_1
e_1_2_8_36_1
e_1_2_8_59_1
e_1_2_8_15_1
e_1_2_8_38_1
e_1_2_8_57_1
e_1_2_8_32_1
e_1_2_8_55_1
e_1_2_8_11_1
Centers for Medicare and Medicaid Services (e_1_2_8_21_1) 2018
e_1_2_8_34_1
e_1_2_8_53_1
e_1_2_8_51_1
e_1_2_8_30_1
e_1_2_8_29_1
e_1_2_8_25_1
e_1_2_8_46_1
e_1_2_8_27_1
e_1_2_8_48_1
e_1_2_8_4_1
e_1_2_8_6_1
e_1_2_8_8_1
e_1_2_8_42_1
e_1_2_8_23_1
e_1_2_8_44_1
Smedley B (e_1_2_8_2_1) 2002
e_1_2_8_63_1
e_1_2_8_40_1
e_1_2_8_18_1
e_1_2_8_39_1
Boyd RW (e_1_2_8_61_1) 2020
e_1_2_8_14_1
e_1_2_8_35_1
e_1_2_8_16_1
e_1_2_8_37_1
e_1_2_8_58_1
e_1_2_8_10_1
e_1_2_8_31_1
e_1_2_8_56_1
e_1_2_8_12_1
e_1_2_8_33_1
e_1_2_8_54_1
Shavers VL (e_1_2_8_62_1) 2007; 99
e_1_2_8_52_1
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SSID ssj0008384
Score 2.3817506
Snippet Objective This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how...
This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how...
Data Source: Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an...
Objective: This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how...
ObjectiveThis study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how...
SourceID pubmedcentral
proquest
gale
crossref
pubmed
wiley
SourceType Open Access Repository
Aggregation Database
Index Database
Publisher
StartPage 507
SubjectTerms Aged
Aged, 80 and over
Averages
Beliefs, opinions and attitudes
Beneficiaries
Black or African American - psychology
Black people
Data collection
Demographic aspects
Disease management
Drugs
Ethnic differences
Ethnic factors
Ethnic groups
Extraction
Female
Government programs
Health aspects
Health Status
Hispanic or Latino - psychology
Hispanic people
Humans
Integrated care
Integrated delivery networks
Integrated delivery systems
Laws, regulations and rules
Male
Medical history
Medicare
Minority & ethnic groups
Multiple regression models
patient assessment/satisfaction
Patient-Centered Care - organization & administration
Patients
Perceptions
Public opinion
Racial groups
Racial Groups - psychology
Racial inequality
racial/ethnic differences in health and health care
Rankings
Regression analysis
Self care
Self-care, Health
Sensitivity analysis
Socioeconomic Factors
Socioeconomic status
Socioeconomics
Specialists
Surveys
United States
White People - psychology
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Title Differences in patient perceptions of integrated care among black, hispanic, and white Medicare beneficiaries
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2F1475-6773.13637
https://www.ncbi.nlm.nih.gov/pubmed/33569775
https://www.proquest.com/docview/2531320084
https://www.proquest.com/docview/2488547914
https://pubmed.ncbi.nlm.nih.gov/PMC8143676
Volume 56
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