Special Article
Primary Care Physicians Who Treat Blacks and Whites
N Engl J Med 2004; 351:575-584August 5, 2004
- Abstract
Background
In the United States, black patients generally receive lower-quality health care than white patients. Black patients may receive their care from a subgroup of physicians whose qualifications or resources are inferior to those of the physicians who treat white patients.
Methods
We performed a cross-sectional analysis of 150,391 visits by black Medicare beneficiaries and white Medicare beneficiaries 65 years of age or older for medical “evaluation and management” who were seen by 4355 primary care physicians who participated in a biannual telephone survey, the 2000–2001 Community Tracking Study Physician Survey.
Results
Most visits by black patients were with a small group of physicians (80 percent of visits were accounted for by 22 percent of physicians) who provided only a small percentage of care to white patients. In a comparison of visits by white patients and black patients, we found that the physicians whom the black patients visited were less likely to be board certified (77.4 percent) than were the physicians visited by the white patients (86.1 percent, P=0.02) and also more likely to report that they were unable to provide high-quality care to all their patients (27.8 percent vs. 19.3 percent, P=0.005). The physicians treating black patients also reported facing greater difficulties in obtaining access for their patients to high-quality subspecialists, high-quality diagnostic imaging, and nonemergency admission to the hospital.
Conclusions
Black patients and white patients are to a large extent treated by different physicians. The physicians treating black patients may be less well trained clinically and may have less access to important clinical resources than physicians treating white patients. Further research should be conducted to address the extent to which these differences may be responsible for disparities in health care.
Media in This Article
Figure 1
Estimated National Distribution of Visits to Primary Care Physicians by White Medicare Beneficiaries and Black Medicare Beneficiaries.Table 1
Characteristics of Primary Care Physicians According to Visits by White and Black Medicare Beneficiaries.Article Activity
- Article
The elimination of racial and ethnic disparities in health care is one of the two goals of the initiative Healthy People 2010 (the other being to increase the quality and years of healthy life), but the causes underlying these disparities have not been established.1 Because patients who are members of minority groups and white patients to some extent reside in different locations and seek their care in different settings, it is possible that doctors who treat these patients may differ with regard to both their clinical qualifications and their clinical resources. We hypothesized that such discrepancies account for the pervasiveness of racial and ethnic disparities in health care.
Several studies support this hypothesis. In a study of primary care physicians in New York City comparing physicians who had patient panels in which less than 50 percent were members of minority groups with physicians whose patient panels included more than 50 percent minority-group patients, Gemson et al. found that those who treated a greater proportion of minority-group patients were less knowledgeable about preventive care practices and less likely to be board certified.2,3 Schneider et al., in a study of managed-care plans, observed that physicians working for plans in which black patients were heavily enrolled provided primary care of a lower quality to all patients in the plan than did physicians working for plans in which fewer black patients were enrolled.4 Differences in qualifications and competency between physicians treating black patients and those treating white patients have also been described with regard to cardiovascular surgery and the care of patients infected with the human immunodeficiency virus.5,6
We studied a nationally representative sample of primary care physicians who treated patients enrolled in Medicare, the nation's largest health insurance plan. We focused on primary care physicians, because they are largely responsible for the coordination of care, often counsel patients regarding the need for referrals to specialists and for diagnostic tests and therapies, and provide continuity of care for many patients with complex diseases. Studies have suggested that poor performance by physicians in these domains may lead to disparities in preventive care, evaluation of symptoms, treatment, and outcome.7-13
Methods
Data
We combined data from two main sources in order to investigate the relation of primary care physicians' training and resources to the race of patients to whom they provide “evaluation and management” services.
Data on Physicians
The Community Tracking Study Physician Survey is a biannual telephone survey conducted by the Center for Studying Health System Change of a nationally representative sample of physicians who are not federally employed. The survey is conducted in 60 randomly selected metropolitan statistical areas and is supplemented by a national sample. In 2000–2001 (round 3 of the survey), the response rate among physicians was 59 percent. Details of the survey are available at www.hschange.org/index.cgi?data=04; many of the findings have been described previously.14-17 The survey included only physicians who reported providing at least 20 hours per week of direct patient care in an office-based or hospital-based practice, including at sites of the Bureau of Primary Health Care of the Department of Health and Human Services. Residents and fellows were excluded. Our study included the participating physicians whose primary specialty was family practice or general practice, general internal medicine, or geriatrics (which we subsumed under the category of internal medicine).
Data on Patient Visits
The Medicare program provides health insurance for 97 percent of Americans who are 65 years of age or older. In 2001, the program covered 40 million persons, 86 percent of whom were enrolled under Part A and Part B indemnity insurance (fee for service), in which providers submit detailed claims to the Centers for Medicare and Medicaid Services for reimbursement for services rendered.18 Data were obtained from the 2001 “5 percent carrier file,” which contains claims histories of a representative sample of 5 percent of Medicare beneficiaries. We analyzed line items for “evaluation and management” that were identified according to the Berenson–Eggers Type of Service Codes used by Medicare: M1A (office visits — new patient), M1B (office visits — established patient), and M6 (consultations), but we excluded items with the Healthcare Common Procedure Coding System codes 99381, 99411, 95115, 99391, 95117, 99236, 99262, 99251, 99255, 99261, 99254, G0175, 99253, and 99252. (Information about the codes is available at www.cms.hhs.gov/data/betos.19) We limited our analysis to data on black Medicare beneficiaries and white Medicare beneficiaries (as documented in Medicare files) 65 years of age or older. Other racial or ethnic categories included in the Medicare data — Hispanic, Asian, North American Native, other, and unknown — are less well studied and less reliable.20-23
Linkage of Data
Data on physicians and patient visits were linked with the use of the physicians' unique provider identification number, which is recorded on claims submitted to Medicare.24 Of 5859 primary care physicians who were interviewed by telephone as part of the Community Tracking Study Physician Survey, 5627 (96.0 percent) had a unique provider identification number. Of these physicians, 729 (13.0 percent) were not associated with claims that appeared in the 2001 Medicare 5 percent carrier file, and 543 (9.6 percent) were associated only with claims that were ineligible for our study — for services other than evaluation and management, or for services rendered to patients who were not black or white and 65 years of age or older. A total of 4355 physicians (77.4 percent) and 43,032 patients were included in our study, and together they contributed 44,756 unique physician–patient pairs (a few patients saw more than one physician included in our study) and 150,391 visits to our analysis. The number of visits per physician ranged from 1 to 304 (median, 24; interquartile range, 10 to 48). These data were used to derive national estimates that reflected the characteristics of 87,803 primary care physicians and of the 58 million visits (by 54 million white patients and 4 million black patients) for evaluation and management that these physicians provided to black and white Medicare beneficiaries 65 years of age or older in the United States in 2001.
Characteristics of Primary Care Physicians
On the basis of their responses to the Community Tracking Study Physician Survey, physicians were characterized according to their demographic characteristics, setting of the practice and mix of payers, medical education, specialty, whether or not they were board certified, and ability to provide access to necessary health care resources for their patients. The demographic characteristics included age, sex, and self-declared race or ethnic background. Information on payer mix and practice setting was based on the reported percentage of revenue the practice derived from Medicare, Medicaid, and managed-care plans, the number and specialties of the physicians in the practice, whether or not physicians provided care for which they received reduced compensation or no compensation (“charity” care), location in an urban area (00-03) or a rural area (04-09), according to metropolitan statistical area codes in the Area Resource File,25 and the income level in the area where the practice was located, according to data from the Census Bureau for 2000 on the median income within the area of a ZIP Code. The site of the physicians' medical education was dichotomized as either the United States, including Puerto Rico, or elsewhere. Board certification was determined for the physicians' primary specialty. Data on each of these measures were missing for less than 1 percent of physicians.
To gain insight into the ability of physicians in the study to provide access to resources for their patients, we analyzed physicians' responses to five questions in the following form: “How often are you able to obtain access for your patients to [type of service] when you think it is necessary?” The five types of service were “subspecialists of high quality,” “ancillary services of high quality,” “nonemergency hospital admissions,” “adequate number of inpatient days,” and “high-quality diagnostic imaging.” The physicians could respond “always,” “almost always,” “frequently,” “sometimes,” “rarely,” and “never.” On the basis of the distribution of the responses, and on our belief that providing high-quality care requires reliable access to such services, we dichotomized the responses into “always” (in which “always” and “almost always” were subsumed) or “not always” (in which the remaining responses were subsumed). Less than 0.25 percent of the responses were missing or in a category not listed, such as “don't know,” and were not included in the analysis.
Physicians were asked to respond to two statements: “It is possible to provide high-quality care to all my patients,” and “The level of communication I have with specialists about the patients I refer to them is sufficient to ensure the delivery of high-quality care.” We dichotomized the responses into “agree” (in which “strongly agree” and “somewhat agree” were subsumed) or “disagree” (in which “strongly disagree” and “somewhat disagree” were subsumed). Less than 3 percent of the responses were missing, “neither agree nor disagree,” or in a category not shown, such as “don't know”; these responses were not included in the analysis.
Statistical Analysis
The unit of analysis was the patient visit. For statistical purposes, the visits were nested within unique physician–patient pairs. Some patients saw more than one physician and therefore contributed to more than one physician–patient pair. Many physicians were part of multiple physician–patient pairs, since they saw multiple patients (individual physicians who saw both black patients and white patients are represented in the counts of both visits by black patients and visits by white patients).
The distribution of visits by black patients and visits by white patients among physicians was estimated by means of logistic regression, with random effects for each physician, with the use of SAS software (version 8.12). The estimated random effects were used to calculate the proportion of black patients in each physician's Medicare patient panel. This approach was used to correct for sampling error.
The responses to the questions in the Community Tracking Study Physician Survey were evaluated with the use of SUDAAN software (version 7.0), to accommodate the multilevel design of the survey.26 Associations between the patient's race and the physician's characteristics were analyzed with the use of unadjusted logistic regression, with the patient's race as the outcome. Associations between the patient's race and the physician's self-reports of access to resources were analyzed with the use of both unadjusted and adjusted logistic regression. In the primary analysis, the race of the patient was the outcome. In the secondary analysis, performed with the use of cumulative logistic regression, the race of the patient was the predictor and the physician's response to the survey question was the ordered outcome.
In the adjusted analysis, we included measures of the payer mix, with binary variables for the categories of charity care and urban or rural location and continuous variables for the proportion of revenue the practice derived from Medicare, Medicaid, and managed-care plans; median income within the area of the ZIP Code of the practice; and the level of the availability of resources in the county in which the practice was located, according to the 2001 Area Resource File. For the analysis of the physicians' ability to gain access to specialists, the measure of available resources was the number of patient care surgeons and medical subspecialists per capita. For the analysis of the physicians' ability to gain access to nonemergency admission and hospital days, the measure of available resources was the number of short-term hospital beds per capita. For the analysis of the physicians' ability to gain access to high-quality imaging, the measure of available resources was the number of patient care radiologists per capita. In a separate analysis (data not shown), adjusted for the median income within the ZIP Code of the patient's residence rather than the ZIP Code of the physician's practice, our findings were similar to those reported here.
To evaluate whether the characteristics of the population of primary care physicians in the geographic area where black patients and white patients received care were similar to those of the physicians who actually saw black patients and white patients in that area, we analyzed data on physicians' characteristics with the use of two geographic categories used in the Dartmouth Atlas of Health Care project: the Hospital Service Area (a small geographic unit) and the Hospital Referral Region (a larger geographic unit) (information on these categories is available at www.dartmouthatlas.org). We analyzed data on all physicians included in our study and generated weighted averages of these characteristics with respect to the geographic location of the visits with black patients and white patients.
Our findings are reported after weighting, which was performed to render them nationally representative. All P values are two-sided. The study was approved by the Center for Medicare and Medicaid Services under Data Use Agreement number 12993. The institutional review board officer at Mathematica Policy Research who oversees the conduct of the Community Tracking Study approved the confidentiality provisions of our study and determined that the Medicare data linkage did not violate the guidelines of the Community Tracking Study.
Results
Distribution of Visits
The distribution of visits by Medicare patients who were white or black among primary care physicians is shown in Figure 1Figure 1
Estimated National Distribution of Visits to Primary Care Physicians by White Medicare Beneficiaries and Black Medicare Beneficiaries., ordered according to the proportion of black patients in each physician's practice. The height of the bars reflects the number of visits by white patients and black patients. The cumulative-distribution Lorenz curves indicate that the bulk of visits by black patients are clustered among physicians whose patient panels include a higher percentage of blacks, whereas only a small percentage of visits by white patients are with these physicians. Visits by white patients are mostly with physicians who provide only a small amount of care to black patients. Of primary care physicians, 78 percent (68,311 physicians) with a relatively small proportion of black patients in their practice account for 78 percent of the visits by white patients but only 20 percent of all visits by black patients, whereas the remaining 22 percent of primary care physicians (19,492) account for 80 percent of all visits by black patients and 22 percent of visits by white patients. If visits by black patients and white patients were equally distributed among physicians, the Lorenz curves in Figure 1 would be superimposed on each other.Characteristics of Physicians
Both primary care physicians treating black patients and those treating white patients were typically near 50 years of age, male, non-Hispanic, and working in solo or two-physician practices in an urban location (Table 1Table 1
Characteristics of Primary Care Physicians According to Visits by White and Black Medicare Beneficiaries.). Even though the majority of visits by both black patients (59.7 percent) and white patients (85.3 percent) were to white physicians, visits by black patients were markedly more likely than visits by white patients to be to black physicians (22.4 percent vs. 0.7 percent). Physicians treating black patients provided more charity care, derived a higher percentage of their practice revenue from Medicaid, more often practiced in low-income neighborhoods, and were less likely to have obtained board certification in their primary specialty (77.4 percent vs. 86.1 percent, P=0.02) than physicians treating white patients.Access to Important Health Care Services
The physicians' assessment of their ability to provide particular aspects of care to their patients also differed with respect to the race of the patient (Table 2Table 2
Primary Care Physicians' Perceptions of the Quality of Care Provided in Relation to the Race of Patient.). When physicians were asked if they were able to provide access to high-quality care for all of their patients, 27.8 percent of physicians treating black patients responded that they could not do so (“disagreed”), as compared with 19.3 percent of physicians treating white patients. They were also more likely than physicians treating white patients to report that they could “not always” provide access for their patients to subspecialists of high quality (24.0 percent vs. 17.9 percent), high-quality diagnostic imaging (24.4 percent vs. 16.6 percent), nonemergency hospital admissions (48.5 percent vs. 37.0 percent), and high-quality ancillary services (36.6 percent vs. 27.7 percent). These findings were significant in both unadjusted and adjusted analyses; the finding with regard to access to specialists was not significant in the cumulative logistic-regression analysis (data not shown).Geographic Differences and Physicians' Characteristics
We assessed whether the differences between physicians treating black patients and those treating white patients were associated with the characteristics of physicians practicing in the geographic areas where black patients and white patients received their care (Table 3Table 3
Characteristics of Primary Care Physicians Who Treated White Patients and Those Who Treated Black Patients and of the Overall Population in the Areas Where Visits Occurred.). This type of geographic explanation of the quality of health care has been explored in other studies of racial differences in health care.27,28 The degree of racial concordance between patient and physician appeared greater than what would be expected if the local availability of physicians of different races were the only explanation of the matching of the patient's and physician's race (Table 3). Of visits by black patients in our study, 22.4 percent were to physicians who were black, whereas in the Hospital Service Areas and Hospital Referral Regions, the percentage of black physicians was lower — 12.5 percent and 6.7 percent, respectively — a finding that supports the hypothesis that black patients preferentially seek care from primary care physicians of their own race.29,30
Other characteristics of the primary care physicians treating white patients and those treating black patients were similar to the overall population of primary care physicians in the geographic areas where the visits occurred. For example, 77.4 percent of visits by black patients were to physicians who were board certified; the average rates of board certification in the areas where the visits occurred were 77.7 percent according to the Hospital Service Area and 80.1 percent according to the Hospital Referral Region.
Discussion
We evaluated the hypothesis that differences between primary care physicians who treat black patients and those who treat white patients play a role in health care disparities. We found that visits by black patients were highly concentrated among a small subgroup of primary care physicians, were more often with physicians who were not board certified in their primary specialty, and were more often with physicians who reported facing obstacles in gaining access to high-quality services for their patients. Each of these observations potentially has implications for disparities in health care.
In our study, the great majority of the visits by black patients (80 percent) were to a small group of primary care physicians (22 percent of the total), whereas the remaining physicians (78 percent) accounted for the majority of visits by white patients. This finding indicates that the care of black patients and white patients rests to a large extent in the hands of different physicians. Disparities in health care could emerge if these two groups of physicians differed in their ability to provide high-quality care, either because of differences in their clinical training or because of differences in their access to resources. In addition, our study shows that it would be possible to identify physicians who treat black patients or who treat white patients through claims databases.
The differences in the rates of board certification between the two groups of physicians support the notion that the poorer quality of care received by black patients may in part result from the fact that their physicians are less well trained than those who mostly treat white patients. For instance, the rates of screening for most diseases are lower among black patients than among white patients, and black patients more often than white patients receive diagnoses when diseases are at a relatively advanced stage. Previous research has shown that physicians who scored poorly on their licensure examinations or who are not board certified in their specialty are less likely to follow screening recommendations and more likely to prescribe symptom-directed treatment, rather than diagnosis-directed treatment — tendencies that may result in delayed diagnoses.31-35
The differences in physicians' reported ease of access to services for their patients point to additional mechanisms underlying health care disparities. Differences in access to subspecialists, imaging studies, nonemergency hospital admission, and ancillary services might help explain why black patients see fewer subspecialists and receive less timely treatment for complex chronic illnesses than do white patients.36-39
Our findings should be interpreted within the context of the data that we analyzed. The responses of physicians regarding access to resources are necessarily subjective and reflect the physicians' experience with all their patients, not only with the Medicare patients included in our analysis. Moreover, we cannot be certain of the extent to which differences in physicians' responses signify differences in the care that their patients received, because we did not examine patients' outcomes. We could not consider the role of some other identified deficiencies in primary care of black patients. For example, predominantly black communities have fewer primary care doctors than predominantly white communities; black patients are more likely than white patients to receive care in inpatient and emergency-department settings, rather than outpatient settings; and a larger fraction of visits for primary care by black patients are to physicians with whom the patients do not have an established relationship.40-42
Because health care disparities are pervasive and because the disparities are not due solely to differences in the patients' insurance coverage, hypotheses regarding the role of physicians in their genesis have emerged. One hypothesis is that most physicians, because they are not black, lack the necessary cultural competence needed to treat black patients effectively.43 To redress this problem, many organizations have recommended that the physician workforce be enriched with more physicians who are members of minority groups and that training in cultural competence be mandated.44 Our findings provide an indication of the extent to which black patients are currently receiving care from black physicians and of the extent to which these patients appear to make a special effort to do so.45-49
Without vitiating these hypotheses, our findings reveal other imbalances in the health care system that may underlie disparities in the delivery of health care. Black patients in the Medicare program, and presumably other black patients as well, are treated by a group of physicians who may differ in important ways from the physicians who treat white patients. That these differences reflect characteristics of the physicians who practice where black persons and white persons receive care suggests that our findings are the result of the distribution of physicians in the United States and not patients' choice. Further research is needed to evaluate the extent to which differences in training and resources between physicians who treat black patients and physicians who treat white patients affect patients' outcomes. Then, we could explore whether efforts to reduce disparities in the provision of health care should be focused on improving the care that physicians who treat black patients are able to deliver.
Supported by grants from the American Lung Association of New York City, the National Cancer Institute (K23CA86968 and RO1CA090226, to Dr. Bach), the American Cancer Society (RSGT-04-012-01-CPPB, to Dr. Schrag), and the Robert Wood Johnson Foundation for research performed at the Center for Studying Health System Change and for support of analytic programming (to Drs. Pham and Hargraves).
We are indebted to the physician respondents to the Community Tracking Study; to Colin B. Begg, Frank Potter, and Elyn Riedel for statistical guidance; to Shannon S. Carson, Katrina Donahue, Beth Virnig, Paul B. Ginsburg, and Bob Konrad for helpful comments; and to Ellen Singer, Beny Wu, Cynthia Saiontz-Martinez, and Gary Moore at Social & Scientific Systems (Silver Spring, Md.) for programming assistance.
Source Information
From the Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York (P.B.B., D.S., R.C.T.); and the Center for Studying Health System Change, Washington, D.C. (H.H.P., J.L.H.).
Address reprint requests to Dr. Bach at the Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., Box 221, New York, NY 10021.
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- Citing Articles (223)
Citing Articles
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Kirk D. Henny, Nicole Crepaz, Cynthia M. Lyles, Khiya J. Marshall, Latrina W. Aupont, Elizabeth D. Jacobs, Adrian Liau, Sima Rama, Linda S. Kay, Leigh A. Willis, Mahnaz R. Charania. (2012) Efficacy of HIV/STI Behavioral Interventions for Heterosexual African American Men in the United States: A Meta-Analysis. AIDS and Behavior
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Samuel T. Savitz. (2012) Literature-Based Appraisal of Racial/Ethnic Cardiovascular Health Care Disparities. ISRN Public Health 2012, 1-7
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R. E. Patzer, J. P. Perryman, J. D. Schrager, S. Pastan, S. Amaral, J. A. Gazmararian, M. Klein, N. Kutner, W. M. McClellan. (2012) The Role of Race and Poverty on Steps to Kidney Transplantation in the Southeastern United States. American Journal of Transplantationno-no
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Quoc-Dien Trinh, Maxine Sun, Jesse Sammon, Marco Bianchi, Shyam Sukumar, Khurshid R. Ghani, Wooju Jeong, Ali Dabaja, Shahrokh F. Shariat, Paul Perrotte, Piyush K. Agarwal, Craig G. Rogers, James O. Peabody, Mani Menon, Pierre I. Karakiewicz. (2012) Disparities in access to care at high-volume institutions for uro-oncologic procedures. Cancern/a-n/a
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Alyna T. Chien, Kristen Wroblewski, Cheryl Damberg, Thomas R. Williams, Dolores Yanagihara, Yelena Yakunina, Lawrence P. Casalino. (2011) Do Physician Organizations Located in Lower Socioeconomic Status Areas Score Lower on Pay-for-Performance Measures?. Journal of General Internal Medicine
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Heena P. Santry, Sherry M. Wren. (2011) The Role of Unconscious Bias in Surgical Safety and Outcomes. Surgical Clinics of North America
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Karim Alavi, J. A. Cervera-Servin, Paul R. Sturrock, W. B. Sweeney, Justin A. Maykel. (2011) Racial Differences in Short-term Surgical Outcomes Following Surgery for Diverticulitis. Journal of Gastrointestinal Surgery
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Caleb Holtzer, F. John Meaney, Jennifer Andrews, Emma Ciafaloni, Deborah J. Fox, Katherine A. James, Zhenqiang Lu, Lisa Miller, Shree Pandya, Lijing Ouyang, Christopher Cunniff. (2011) Disparities in the diagnostic process of Duchenne and Becker muscular dystrophy. Genetics in Medicine 13:11, 942-947
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Abigail E Wilkes, Kristine Bordenave, Lisa Vinci, Monica E Peek. (2011) Addressing diabetes racial and ethnic disparities: lessons learned from quality improvement collaboratives. Diabetes Management 1:6, 653-660
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Aparna Padiyar, Donald E Hricik. (2011) Immune factors influencing ethnic disparities in kidney transplantation outcomes. Expert Review of Clinical Immunology 7:6, 769-778
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Debra Nana Yeboa, Thomas Guzzo, Nandita Mitra, John P. Christodouleas, Naomi B. Haas, Neha Vapiwala, Katrina Armstrong, Justin E. Bekelman. (2011) Prostate-specific Antigen Surveillance Among Men With Clinically Localized Prostate Cancer Who Do Not Receive Initial Treatment. Urology 78:5, 1107-1113
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Renee Y. Hsia, Tanja Srebotnjak, Hemal K. Kanzaria, Charles McCulloch, Andrew D. Auerbach. (2011) System-Level Health Disparities in California Emergency Departments: Minorities and Medicaid Patients Are at Higher Risk of Losing Their Emergency Departments. Annals of Emergency Medicine
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Bruce L. Jacobs, Jeffrey S. Montgomery, Yun Zhang, Ted A. Skolarus, Alon Z. Weizer, Brent K. Hollenbeck. (2011) Disparities in bladder cancer. Urologic Oncology: Seminars and Original Investigations
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Hilary F. Byrnes, Brenda A. Miller, Annette E. Aalborg, Carolyn D. Keagy. (2011) The Relationship Between Neighborhood Characteristics and Recruitment into Adolescent Family-Based Substance Use Prevention Programs. The Journal of Behavioral Health Services & Research
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Craig Evan Pollack, Justin E. Bekelman, Andrew J. Epstein, Kaijun Liao, Yu-Ning Wong, Katrina Armstrong. (2011) Racial Disparities in Changing to a High-volume Urologist Among Men With Localized Prostate Cancer. Medical Care1
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I. Hayes, K. Enohumah, C. McCaul. (2011) Care of the migrant obstetric population. International Journal of Obstetric Anesthesia 20:4, 321-329
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Courtney R. Lyles, Andrew J. Karter, Bessie A. Young, Clarence Spigner, David Grembowski, Dean Schillinger, Nancy Adler. (2011) Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE). Journal of General Internal Medicine 26:10, 1138-1144
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Barbara L. Wilson, Bonnie Gance-Cleveland, Tiffany L. Locus. (2011) Ethnicity and Newborn Outcomes: The Case of African American Women. Journal of Nursing Scholarshipno-no
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Craig Evan Pollack, Gary Weissman, Justin Bekelman, Kaijun Liao, Katrina Armstrong. (2011) Physician Social Networks and Variation in Prostate Cancer Treatment in Three Cities. Health Services Researchn/a-n/a
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Emily R. Carrier, Eric Schneider, Hoangmai H. Pham, Peter B. Bach. (2011) Association Between Quality of Care and the Sociodemographic Composition of Physicians’ Patient Panels: A Repeat Cross-Sectional Analysis. Journal of General Internal Medicine 26:9, 987-994
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Emily Russell, Michael R. Kramer, Hannah L. F. Cooper, Winifred Wilkins Thompson, Kimberly R. Jacob Arriola. (2011) Residential Racial Composition, Spatial Access to Care, and Breast Cancer Mortality among Women in Georgia. Journal of Urban Health
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John H. Sampson, Carlos A. Bagley, Benjamin S. Carson. (2011) Editorial. Journal of Neurosurgery1-2
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A. K. Mathur, D. E. Schaubel, Qi Gong, M. K. Guidinger, R. M. Merion. (2011) Sex-Based Disparities in Liver Transplant Rates in the United States. American Journal of Transplantation 11:7, 1435-1443
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Arora, Sanjeev, Thornton, Karla, Murata, Glen, Deming, Paulina, Kalishman, Summers, Dion, Denise, Parish, Brooke, Burke, Thomas, Pak, Wesley, Dunkelberg, Jeffrey, Kistin, Martin, Brown, John, Jenkusky, Steven, Komaromy, Miriam, Qualls, Clifford, . (2011) Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers. New England Journal of Medicine 364:23, 2199-2207
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Rosalie F. Young, Kendra Schwartz, Jason Booza. (2011) Medical Barriers to Mammography Screening of African American Women in a High Cancer Mortality Area: Implications for Cancer Educators and Health Providers. Journal of Cancer Education 26:2, 262-269
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E. Ray Dorsey, Sean Nicholson, William H. Frist. (2011) Commentary: Improving the Supply and Distribution of Primary Care Physicians. Academic Medicine 86:5, 541-543
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Thomas D. Sequist, Theresa Cullen, Kenneth Bernard, Shimon Shaykevich, E. John Orav, John Z. Ayanian. (2011) Trends in Quality of Care and Barriers to Improvement in the Indian Health Service. Journal of General Internal Medicine 26:5, 480-486
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Thomas J. Semrad, Daniel J. Tancredi, Laura-Mae Baldwin, Pamela Green, Joshua J. Fenton. (2011) Geographic variation of racial/ethnic disparities in colorectal cancer testing among medicare enrollees. Cancer 117:8, 1755-1763
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Raina M. Merchant, Lance B. Becker, Feifei Yang, Peter W. Groeneveld. (2011) Hospital racial composition: A neglected factor in cardiac arrest survival disparities. American Heart Journal 161:4, 705-711
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Douglas E. Levy, Stacey D. Byfield, Catherine B. Comstock, Judy E. Garber, Sapna Syngal, William H. Crown, Alexandra E. Shields. (2011) Underutilization of BRCA1/2 testing to guide breast cancer treatment: Black and Hispanic women particularly at risk. Genetics in Medicine 13:4, 349-355
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Jung-won Lim, Kimlin T. Ashing-Giwa. (2011) Examining the effect of minority status and neighborhood characteristics on cervical cancer survival outcomes. Gynecologic Oncology 121:1, 87-93
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Arica White, Ann L. Coker, Xianglin L. Du, Katherine S. Eggleston, Melanie Williams. (2011) Racial/ethnic disparities in survival among men diagnosed with prostate cancer in Texas. Cancer 117:5, 1080-1088
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Sara E. Erickson, Eduard E. Vasilevskis, Michael W. Kuzniewicz, Brian A. Cason, Rondall K. Lane, Mitzi L. Dean, Deborah J. Rennie, R. Adams Dudley. (2011) The effect of race and ethnicity on outcomes among patients in the intensive care unit: A comprehensive study involving socioeconomic status and resuscitation preferences*. Critical Care Medicine 39:3, 429-435
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Paul L. Hebert, Mark R. Chassin, Elizabeth A. Howell. (2011) The Contribution of Geography to Black/White Differences in the Use of Low Neonatal Mortality Hospitals in New York City. Medical Care 49:2, 200-206
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Rocco Ricciardi, Patricia L. Roberts, Thomas E. Read, Nancy N. Baxter, Peter W. Marcello, David J. Schoetz. (2011) Presence of Specialty Surgeons Reduces the Likelihood of Colostomy After Proctectomy for Rectal Cancer. Diseases of the Colon & Rectum 54:2, 207-213
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Katrina Armstrong, Thomas C. Randall, Daniel Polsky, Elizabeth Moye, Jeffrey H. Silber. (2011) Racial Differences in Surgeons and Hospitals for Endometrial Cancer Treatment. Medical Care 49:2, 207-214
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Gary L. Freed, Sarah J. Clark, Anne E. Cowan, Margaret S. Coleman. (2011) Primary care physician perspectives on providing adult vaccines. Vaccine 29:9, 1850-1854
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Bahman Roudsari, Raul Caetano, Craig Field. (2011) Alcohol intoxication/dependence, ethnicity and utilisation of health care resources in a level I trauma center. Injury 42:1, 66-71
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Craig Evan Pollack, Justin E. Bekelman, K. J. Liao, Katrina Armstrong. (2011) Hospital racial composition and the treatment of localized prostate cancer. Cancern/a-n/a
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Julie P. W. Bynum, Elliott S. Fisher, Yunjie Song, Jonathan Skinner, Amitabh Chandra. (2010) Measuring Racial Disparities in the Quality of Ambulatory Diabetes Care. Medical Care 48:12, 1057-1063
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Joseph J. Doyle, Steven M. Ewer, Todd H. Wagner. (2010) Returns to physician human capital: Evidence from patients randomized to physician teams. Journal of Health Economics 29:6, 866-882
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Jennifer Marie Suga, Danh V. Nguyen, Sandra M. Mohammed, Monica Brown, Royce Calhoun, Ken Yoneda, David R. Gandara, Primo N. Lara. (2010) Racial Disparities on the Use of Invasive and Noninvasive Staging in Patients with Non-small Cell Lung Cancer. Journal of Thoracic Oncology 5:11, 1772-1778
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Elizabeth M. Ward, Stacey A. Fedewa, Vilma Cokkinides, Katherine Virgo. (2010) The Association of Insurance and Stage at Diagnosis Among Patients Aged 55 to 74 Years in the National Cancer Database. The Cancer Journal 16:6, 614-621
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Ashish K. Jha, Roslyn Stone, Judith Lave, Huanyu Chen, Heather Klusaritz, Kevin Volpp. (2010) The Concentration of Hospital Care for Black Veterans in Veterans Affairs Hospitals: Implications for Clinical Outcomes. Journal for Healthcare Quality 32:6, 52-61
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K. Odom Walker, G. Ryan, R. Ramey, F. L. Nunez, R. Beltran, R. G. Splawn, A. F. Brown. (2010) Recruiting and Retaining Primary Care Physicians in Urban Underserved Communities: The Importance of Having a Mission to Serve. American Journal of Public Health 100:11, 2168-2175
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Emily L. McCave. (2010) Placing HPV Vaccination Within a Social Work Context: The Issue of Access to Care. Smith College Studies in Social Work 80:4, 377-394
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José-Ignacio Antón, Rafael Muñoz de Bustillo. (2010) Health care utilisation and immigration in Spain. The European Journal of Health Economics 11:5, 487-498
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Arica White, Sally W. Vernon, Luisa Franzini, Xianglin L. Du. (2010) Racial disparities in colorectal cancer survival. Cancer 116:19, 4622-4631
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S. Soneji, S. S. Iyer, K. Armstrong, D. A. Asch. (2010) Racial Disparities in Stage-Specific Colorectal Cancer Mortality: 1960-2005. American Journal of Public Health 100:10, 1912-1916
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Enrique R. Pouget, Trace S. Kershaw, Kim M. Blankenship, Jeannette R. Ickovics, Linda M. Niccolai. (2010) Racial/Ethnic Disparities in Undiagnosed Infection With Herpes Simplex Virus Type 2. Sexually Transmitted Diseases 37:9, 538-543
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Ravishankar Jayadevappa, S. Bruce Malkowicz, Sumedha Chhatre, Joseph Gallo, J. Sanford Schwartz. (2010) Racial and ethnic variation in health resource use and cost for prostate cancer. BJU International 106:6, 801-808
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Catherine Lee, John D. Skrentny. (2010) Race Categorization and the Regulation of Business and Science. Law & Society Review 44:3-4, 617-650
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L. C. Richardson, J. Royalty, W. Howe, W. Helsel, W. Kammerer, V. B. Benard. (2010) Timeliness of Breast Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program, 1996-2005. American Journal of Public Health 100:9, 1769-1776
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Wael Hakmeh, Jarrod Barker, Susan M. Szpunar, James M. Fox, Charlene B. Irvin. (2010) Effect of Race and Insurance on Outcome of Pediatric Trauma. Academic Emergency Medicine 17:8, 809-812
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Thomas Isaac, Alan M. Zaslavsky, Paul D. Cleary, Bruce E. Landon. (2010) The Relationship between Patients' Perception of Care and Measures of Hospital Quality and Safety. Health Services Research 45:4, 1024-1040
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Sarah Hill, Diana Sarfati, Tony Blakely, Bridget Robson, Gordon Purdie, Elizabeth Dennett, Donna Cormack, Kevin Dew, John Z. Ayanian, Ichiro Kawachi. (2010) Ethnicity and management of colon cancer in New Zealand. Cancer 116:13, 3205-3214
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Arden M. Morris, Kim F. Rhoads, Steven C. Stain, John D. Birkmeyer. (2010) Understanding Racial Disparities in Cancer Treatment and Outcomes. Journal of the American College of Surgeons 211:1, 105-113
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Ana H. Traylor, Julie A. Schmittdiel, Connie S. Uratsu, Carol M. Mangione, Usha Subramanian. (2010) The Predictors of Patient-Physician Race and Ethnic Concordance: A Medical Facility Fixed-Effects Approach. Health Services Research 45:3, 792-805
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Clara Manfredi, Karen Kaiser, Alicia K. Matthews, Timothy P. Johnson. (2010) Are Racial Differences in Patient–Physician Cancer Communication and Information Explained by Background, Predisposing, and Enabling Factors?. Journal of Health Communication 15:3, 272-292
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Robert H. Keefe. (2010) Health Disparities: A Primer for Public Health Social Workers. Social Work in Public Health 25:3-4, 237-257
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Dan P. Ly, Sherry A. Glied. (2010) Disparities in Service Quality Among Insured Adult Patients Seen in Physicians’ Offices. Journal of General Internal Medicine 25:4, 357-362
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Marc N. Turenne, Richard A. Hirth, Joseph M. Messana, Jason S. Turner, Kathryn K. Sleeman, John R. C. Wheeler. (2010) When Payment Systems Collide. Medical Care 48:4, 296-305
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Sasigant S. O'Neil, Timothy Lake, Angela Merrill, Ander Wilson, David A. Mann, Linda M. Bartnyska. (2010) Racial Disparities in Hospitalizations for Ambulatory Care–Sensitive Conditions. American Journal of Preventive Medicine 38:4, 381-388
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Gregory M. Marcus, Jeffrey E. Olgin, Mary Whooley, Eric Vittinghoff, Katie L. Stone, Reena Mehra, Stephen B. Hulley, Nelson B. Schiller. (2010) Racial Differences in Atrial Fibrillation Prevalence and Left Atrial Size. The American Journal of Medicine 123:4, 375.e1-375.e7
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William T. Curry, Bob S. Carter, Fred G. Barker. (2010) Racial, Ethnic, and Socioeconomic Disparities in Patient Outcomes After Craniotomy for Tumor in Adult Patients in the United States, 1988–2004. Neurosurgery 66:3, 427-438
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Jason Q. Purnell, Mira L. Katz, Barbara L. Andersen, Oxana Palesh, Colmar Figueroa-Moseley, Pascal Jean-Pierre, Nancy Bennett. (2010) Social and cultural factors are related to perceived colorectal cancer screening benefits and intentions in African Americans. Journal of Behavioral Medicine 33:1, 24-34
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Robert J. Richards, Stephen Crystal. (2010) The Frequency of Early Repeat Tests After Colonoscopy in Elderly Medicare Recipients. Digestive Diseases and Sciences 55:2, 421-431
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Deborah Carr, Yoko Ibuka, Louise B. Russell. 2010. How much time do Americans spend seeking health care? Racial and ethnic differences in patient experiences. , 71-98.
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Luke J. Hofmann, Sukhyung Lee, Brad Waddell, Kurt G. Davis. (2010) Effect of Race on Colon Cancer Treatment and Outcomes in the Department of Defense Healthcare System. Diseases of the Colon & Rectum 53:1, 9-15
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Vicki Dryfhout. 2010. Racial disparities in stillbirths. , 151-174.
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Craig A. Umscheid, Robert Gross, Mark G. Weiner, Christopher S. Hollenbeak, Simon S.K. Tang, Barbara J. Turner. (2010) Racial Disparities in Hypertension Control, but Not Treatment Intensification. American Journal of Hypertension 23:1, 54-61
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Kyla M. Bennett, John E. Scarborough, Theodore N. Pappas, Thomas B. Kepler. (2010) Patient Socioeconomic Status Is an Independent Predictor of Operative Mortality. Transactions of the ... Meeting of the American Surgical Association 128, 157-165
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Saif S. Rathore, Jonathan D. Ketcham, G. Caleb Alexander, Andrew J. Epstein. (2009) Influence of Patient Race on Physician Prescribing Decisions: A Randomized On-Line Experiment. Journal of General Internal Medicine 24:11, 1183-1191
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Anne Beal, Susan Hernandez, Michelle Doty. (2009) Latino Access to the Patient-Centered Medical Home. Journal of General Internal Medicine 24:S3, 514-520
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Nicholas G. Csikesz, Anand Singla, Jessica P. Simons, Jennifer F. Tseng, Shimul A. Shah. (2009) The Impact of Socioeconomic Status on Presentation and Treatment of Diverticular Disease. Journal of Gastrointestinal Surgery 13:11, 1993-2002
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Melissa M. Murphy, Jessica P. Simons, Sing Chau Ng, Theodore P. McDade, Jillian K. Smith, Shimul A. Shah, Zheng Zhou, Craig C. Earle, Jennifer F. Tseng. (2009) Racial Differences in Cancer Specialist Consultation, Treatment, and Outcomes for Locoregional Pancreatic Adenocarcinoma. Annals of Surgical Oncology 16:11, 2968-2977
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Nicholas H. Osborne, Gilbert R. Upchurch, Amit K. Mathur, Justin B. Dimick. (2009) Explaining racial disparities in mortality after abdominal aortic aneurysm repair. Journal of Vascular Surgery 50:4, 709-713
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Joseph Telfair, Suzanne M. Bronheim, Sharonlyn Harrison. (2009) Implementation of Culturally and Linguistically Competent Policies by State Title V Children with Special Health Care Needs (CSHCN) Programs. Maternal and Child Health Journal 13:5, 677-686
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Sandra Suther, Gebre-Egziabher Kiros. (2009) Barriers to the use of genetic testing: A study of racial and ethnic disparities. Genetics in Medicine 11:9, 655-662
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Nancy L. Keating, Elena Kouri, Yulei He, Jane C. Weeks, Eric P. Winer. (2009) Racial Differences in Definitive Breast Cancer Therapy in Older Women. Medical Care 47:7, 765-773
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Hector M. González, Wassim Tarraf, Brady T. West, Thomas W. Croghan, Mary E. Bowen, Zhun Cao, Margarita Alegría. (2009) Antidepressant use in a nationally representative sample of community-dwelling US Latinos with and without depressive and anxiety disorders. Depression and Anxiety 26:7, 674-681
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Cathy J. Bradley, Bassam Dahman, Charles W. Given. (2009) Inadequate Access to Surgeons. Medical Care 47:7, 758-764
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Angus Deaton, Darren Lubotsky. (2009) Income inequality and mortality in U.S. cities: Weighing the evidence. A response to Ash. Social Science & Medicine 68:11, 1914-1917
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Awori Jeremiah Hayanga, Heather E. Kaiser, Rakhi Sinha, Sean M. Berenholtz, Marty Makary, David Chang. (2009) Residential Segregation and Access to Surgical Care by Minority Populations in US Counties. Journal of the American College of Surgeons 208:6, 1017-1022
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Myra G. Schneider, Christopher J. Swearingen, Lisa M. Shulman, Jian Ye, Mona Baumgarten, Barbara C. Tilley. (2009) Minority enrollment in Parkinson's disease clinical trials. Parkinsonism & Related Disorders 15:4, 258-262
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Florina Constantinescu, Suzanne Goucher, Arthur Weinstein, Wally Smith, Liana Fraenkel. (2009) Understanding why rheumatoid arthritis patient treatment preferences differ by race. Arthritis & Rheumatism 61:4, 413-418
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(2009) Racially Based Disparities in Pain Management: Something Old, Something New, But What to Do?. Pain Medicine 10:3, 432-434
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A. H. G. M. Spithoven. (2009) Why U.S. health care expenditure and ranking on health care indicators are so different from Canada’s. International Journal of Health Care Finance and Economics 9:1, 1-24
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Chu-Lin Tsai, Carlos A Camargo Jr. (2009) Racial and Ethnic Differences in Emergency Care for Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Academic Emergency Medicine 16:2, 108-115
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Amitabh Chandra. (2009) Who You Are and Where You Live. Medical Care 47:2, 135-137
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Diana J. Burgess, Adam A. Powell, Joan M. Griffin, Melissa R. Partin. (2009) Race and the validity of self-reported cancer screening behaviors: Development of a conceptual model. Preventive Medicine 48:2, 99-107
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Ashish K. Jha, David W. Bates, Chelsea Jenter, E. John Orav, Jie Zheng, Paul Cleary, Steven R. Simon. (2009) Electronic health records: Use, barriers and satisfaction among physicians who care for black and Hispanic patients. Journal of Evaluation in Clinical Practice 15:1, 158-163
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Alyna T. Chien, Marshall H. Chin. (2009) Incorporating Disparity Reduction into Pay-for-Performance. Journal of General Internal Medicine 24:1, 135-136
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Scott E. Regenbogen, Atul A. Gawande, Stuart R. Lipsitz, Caprice C. Greenberg, Ashish K. Jha. (2009) Do Differences in Hospital and Surgeon Quality Explain Racial Disparities in Lower-Extremity Vascular Amputations?. Transactions of the ... Meeting of the American Surgical Association 127, 68-75
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Brent K. Hollenbeck, Rodney L. Dunn, Zaojun Ye, John M. Hollingsworth, Cheryl T. Lee, John D. Birkmeyer. (2009) Racial differences in treatment and outcomes among patients with early stage bladder cancer. CancerNA-NA
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Nestor F. Esnaola, Mulugeta Gebregziabher, Chris Finney, Marvella E. Ford. (2009) Underuse of Surgical Resection in Black Patients With Nonmetastatic Colorectal Cancer. Transactions of the ... Meeting of the American Surgical Association 127, 180-188
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N. A. Bickell, K. Shastri, K. Fei, S. Oluwole, H. Godfrey, K. Hiotis, A. Srinivasan, A. A. Guth. (2008) A Tracking and Feedback Registry to Reduce Racial Disparities in Breast Cancer Care. JNCI Journal of the National Cancer Institute 100:23, 1717-1723
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P. Todd Korthuis, Somnath Saha, John A. Fleishman, Moriah McSharry McGrath, Joshua S. Josephs, Richard D. Moore, Kelly A. Gebo, James Hellinger, Mary Catherine Beach, . (2008) Impact of Patient Race on Patient Experiences of Access and Communication in HIV Care. Journal of General Internal Medicine 23:12, 2046-2052
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Deidra D. Parrish, Charlotte K. Kent. (2008) Access to Care Issues for African American Communities: Implications for STD Disparities. Sexually Transmitted Diseases 35:Supplement, S19-S22
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Dae Hyun Kim, Constantine Daskalakis, Andrew N. Lee, Suzanne Adams, Sam Hohmann, Scott C. Silvestry, Sofia Medvedev, David J. Whellan. (2008) Racial Disparity in the Relationship Between Hospital Volume and Mortality Among Patients Undergoing Coronary Artery Bypass Grafting. Annals of Surgery 248:5, 886-892
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Karen E. Lutfey, Stephen M. Campbell, Megan R. Renfrew, Lisa D. Marceau, Martin Roland, John B. McKinlay. (2008) How are patient characteristics relevant for physicians' clinical decision making in diabetes? An analysis of qualitative results from a cross-national factorial experiment. Social Science & Medicine 67:9, 1391-1399
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Kyna M. Gooden, Daniel L. Howard, William R. Carpenter, April P. Carson, Yhenneko J. Taylor, Sharon Peacock, Paul A. Godley. (2008) The Effect of Hospital and Surgeon Volume on Racial Differences in Recurrence-Free Survival After Radical Prostatectomy. Medical Care 46:11, 1170-1176
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G. Eric Jarvis. (2008) Changing psychiatric perception of African Americans with psychosis. European Journal of American Culture 27:3, 227-252
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Jennifer S. Haas, Craig C. Earle, John E. Orav, Phyllis Brawarsky, Marie Keohane, Bridget A. Neville, David R. Williams. (2008) Racial segregation and disparities in breast cancer care and mortality. Cancer 113:8, 2166-2172
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M. E. Bowen, H. M. Gonzalez. (2008) Racial/Ethnic Differences in the Relationship Between the Use of Health Care Services and Functional Disability: The Health and Retirement Study (1992-2004). The Gerontologist 48:5, 659-667
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CHARLES RV TOMSON, ROBERT N FOLEY, QI LI, DAVID T GILBERTSON, JAY L XUE, ALLAN J COLLINS. (2008) Race and end-stage renal disease in the United States Medicare population: The disparity persists. Nephrology 13:7, 651-656
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Hector P. Rodriguez, Ted Glahn, David E. Grembowski, William H. Rogers, Dana Gelb Safran. (2008) Physician Effects on Racial and Ethnic Disparities in Patients’ Experiences of Primary Care. Journal of General Internal Medicine 23:10, 1666-1672
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Peter B. Bach. (2008) Do Surgical Quality Gaps Cause Healthcare Disparities?. Medical Care 46:9, 889-892
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K Hebert, B Lopez, J Castellanos, A Palacio, L Tamariz, L M Arcement. (2008) The prevalence of erectile dysfunction in heart failure patients by race and ethnicity. International Journal of Impotence Research 20:5, 507-511
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Nancy J. O. Birkmeyer, Niya Gu, Onur Baser, Arden M. Morris, John D. Birkmeyer. (2008) Socioeconomic Status and Surgical Mortality in the Elderly. Medical Care 46:9, 893-899
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Julia E. Heck, Steven M. Albert, Rebeca Franco, Sherri Sheinfeld Gorin. (2008) Patterns of Dementia Diagnosis in Surveillance, Epidemiology, and End Results Breast Cancer Survivors Who Use Chemotherapy. Journal of the American Geriatrics Society 56:9, 1687-1692
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Chaya S. Moskowitz, Venkatraman E. Seshan, Elyn R. Riedel, Colin B. Begg. (2008) Estimating the empirical Lorenz curve and Gini coefficient in the presence of error with nested data. Statistics in Medicine 27:16, 3191-3208
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Roberto B. Vargas, Gery W. Ryan, Catherine A. Jackson, Rian Rodriguez, Harold P. Freeman. (2008) Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer. Cancer 113:2, 426-433
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Michael L. Steinberg. (2008) Inequity in Cancer Care: Explanations and Solutions for Disparity. Seminars in Radiation Oncology 18:3, 161-167
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Liqian Liu, Ann L. Coker, Xianglin L. Du, Janice N. Cormier, Charles E. Ford, Shenying Fang. (2008) Long-term survival after radical prostatectomy compared to other treatments in older men with local/regional prostate cancer. Journal of Surgical Oncology 97:7, 583-591
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Aaron W. Calhoun, Gordon H. Guyatt, Michael D. Cabana, Downing Lu, David A. Turner, Stacey Valentine, Adrienne G. Randolph. (2008) Addressing the Unit of Analysis in Medical Care Studies. Medical Care 46:6, 635-643
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RODERICK K. KING, ALEXANDER R. GREEN, ASWITA TAN-McGRORY, ELIZABETH J. DONAHUE, JESSIE KIMBROUGH-SUGICK, JOSEPH R. BETANCOURT. (2008) A Plan for Action: Key Perspectives from the Racial/Ethnic Disparities Strategy Forum. The Milbank Quarterly 86:2, 241-272
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