Special Article
Trends in the Quality of Care and Racial Disparities in Medicare Managed Care
N Engl J Med 2005; 353:692-700August 18, 2005
- Abstract
Background
Since 1997, all managed-care plans administered by Medicare have reported on quality-of-care measures from the Health Plan Employer Data and Information Set (HEDIS). Studies of early data found that blacks received care that was of lower quality than that received by whites. In this study, we assessed changes over time in the overall quality of care and in the magnitude of racial disparities in nine measures of clinical performance.
Methods
In order to compare the quality of care for elderly white and black beneficiaries enrolled in Medicare managed-care plans who were eligible for at least one of nine HEDIS measures, we analyzed 1.8 million individual-level observations from 183 health plans from 1997 to 2003. For each measure, we assessed whether the magnitude of the racial disparity had changed over time with the use of multivariable models that adjusted for the age, sex, health plan, Medicaid eligibility, and socioeconomic position of beneficiaries on the basis of their area of residence.
Results
During the seven-year study period, clinical performance improved on all measures for both white enrollees and black enrollees (P<0.001). The gap between white beneficiaries and black beneficiaries narrowed for seven HEDIS measures (P<0.01). However, racial disparities did not decrease for glucose control among patients with diabetes (increasing from 4 percent to 7 percent, P<0.001) or for cholesterol control among patients with cardiovascular disorders (increasing from 14 percent to 17 percent; change not significant, P=0.72).
Conclusions
The measured quality of care for elderly Medicare beneficiaries in managed-care plans improved substantially from 1997 to 2003. Racial disparities declined for most, but not all, HEDIS measures we studied. Future research should examine factors that contributed to the narrowing of racial disparities on some measures and focus on interventions to eliminate persistent disparities in the quality of care.
Media in This Article
Figure 1
Trends in Receipt of Two HEDIS Measures for Enrollees in Medicare Managed-Care Plans, by Race.Table 1
Description of HEDIS Measures of Quality of Care.Article Activity
- Article
Despite decades of impressive scientific and clinical innovations, substantial deficiencies persist in the quality of health care in the United States,1-3 and troubling disparities exist in the quality of care for racial and ethnic minorities.4-8 Efforts to improve the quality of health care and attempts to reduce disparities in treatment may be connected, because variations in appropriate care that are not caused by clinical factors or by the informed preferences of patients are, by definition, indicators of suboptimal care.9
Recently, signs of an improved quality of care have been evident both within and outside managed-care settings.10-12 These improvements may be related to efforts to measure and report clinical performance. However, little is known about whether general improvements in the quality of care are also accompanied by reductions in racial and ethnic disparities. Quality-improvement efforts may reduce such disparities, but they also may have no effect or even increase disparities.
A recent study of patients with end-stage renal disease suggested that broadly targeted interventions to improve the quality of care were associated with reduced racial disparities in hemodialysis dosing.13 However, an analysis of the administration of influenza vaccine to Medicare beneficiaries showed that higher rates of vaccination in managed-care plans, as compared with the rates in fee-for-service plans, were not associated with reduced disparities on the basis of race.7
Within the Medicare program, managed-care plans provide an opportune setting to examine the relation between improvements in the quality of health care and changes in racial disparities. Health plans are particularly well positioned to improve care, because they finance and monitor the provision of health services to enrollees.12,14 Since 1997, all health plans participating in Medicare have been required to submit publicly reported performance measures from the Health Plan Employer Data and Information Set (HEDIS) developed by the National Committee for Quality Assurance (NCQA). In previous studies of HEDIS measures, black enrollees were less likely to receive beta-blockers after myocardial infarction, eye examinations after receiving a diagnosis of diabetes, follow-up care after hospitalization for mental illness, and influenza vaccinations.6,8
In this study, we report on trends in the quality of care provided to enrollees in Medicare managed-care plans from 1997 to 2003 and assess whether racial disparities in quality changed during this period. Evaluation of HEDIS performance trends by race can provide important information about whether broad improvements are associated with narrowed or widened racial disparities in the quality of medical care.15
Methods
Study Population
We obtained HEDIS data for Medicare managed-care plans from the Centers for Medicare and Medicaid Services (CMS) covering seven reporting years (1998 to 2004) with information regarding clinical care that was delivered from 1997 to 2003. These data contained 2,691,482 observations for enrollees who were eligible for at least one of the nine HEDIS indicators described in Table 1Table 1
Description of HEDIS Measures of Quality of Care.. Each observation included the patient's health identification code and health plan, as well as variables indicating eligibility for and adherence to each HEDIS measure.NCQA developed detailed specifications for measures that define criteria for inclusion in the sample and the method for the calculation of adherence to each HEDIS quality indicator. To ensure that health plans prepared data in accordance with NCQA specifications and that the data would be valid for use in health plan comparisons, the CMS conducted two audits of HEDIS reporting by Medicare managed-care plans during 1998. The audits included a review of data systems, interviews with health plan personnel, and a centralized review of medical records. In the initial phase of these audits, 90.3 to 96.6 percent of health plans that reported data were fully compliant with the technical specifications of the three HEDIS measures of effectiveness of care. After completion of the audit, all plan-reported rates were within 1 percentage point of audit-derived rates.16
Using the health identification code, we matched each enrollee with HEDIS data on at least one measure with the file of Medicare enrollees for the corresponding year to obtain demographic information on the race, age, sex, and ZIP Code of residence of beneficiaries and to ascertain whether they also had Medicaid coverage. We achieved a match rate of 96 percent, or 2,573,166 observations. We excluded 229,938 observations for enrollees who were under the age of 65 years, 201,323 observations for enrollees who were of a race or ethnic background other than black or white, and 44,150 observations for enrollees who died during the year of measurement (with some overlap of enrollees in these three exclusion categories). This process yielded a total study sample of 2,122,809 observations, of which 9.2 percent were for black enrollees. To reduce the likelihood that trends in performance and disparities might be a result of the entrance and exit of health plans from Medicare, our primary analysis excluded 319,358 observations from health plans with less than five years of continuous participation in Medicare managed care. (In a secondary analysis, we did not exclude health plans with less than five years of participation and instead included observations for eligible patients from all health plans that participated in Medicare managed care for at least one year during the study period. Results were similar and are not shown.)
The primary study sample included 1,803,451 observations (9.4 percent for black enrollees) from 183 health plans for the nine HEDIS indicators. The sample size of observations over the entire study period ranged from 79,133 for the beta-blocker measure to 1,035,946 for the breast-cancer-screening measure.
Study Variables
Our dependent variables were the receipt of each HEDIS indicator (Table 1) by eligible enrollees. Our chief independent variable was black or white race, and these designations are highly accurate in Medicare enrollment data.17 Covariates included age, sex, enrollment in Medicaid, the percentage of persons 65 years of age or older within the enrollee's ZIP Code with an income of less than the federal poverty level, the percentage of persons 65 years of age or older in the enrollee's ZIP Code who had attended college, and urban residence. Data on poverty, educational level, and urban residence within a particular ZIP Code were obtained from the 2000 U.S. Census.
Statistical Analysis
We assessed demographic and socioeconomic characteristics of the population that was eligible for each HEDIS measure. For white enrollees and black enrollees in each year, we calculated the performance for each HEDIS measure as the percentage of eligible enrollees who were reported to have achieved the performance measure.
To determine adjusted rate differences between white enrollees and black enrollees, we fitted separate linear models predicting receipt of each HEDIS measure to each year's data. To assess trends, we fitted models to combined data from the first and last usable year for each measure. We assessed the overall trend in the quality of care by testing the significance of the year effect in the model without a race-by-year interaction. To assess changes in racial disparity on the risk-difference scale, we tested the significance of a race-by-year interaction term.
In order to determine the adjusted effect of variables regarding demographic characteristics, health plan, and socioeconomic factors on racial disparities in the quality of care, we fitted three versions of each of these linear regression models. Adjusted rates and differences then corresponded to those predicted at the mean values of the adjuster variables. The first model adjusted for age and sex. The second model added to the first model variables for rural residence and health plan (defined as a Medicare managed-care contract). Because each contract is typically limited to a specific state (except for a few health plans that serve contiguous areas in adjacent states) and the addition of variables by state did not significantly alter regression results after controlling for health plan, we did not include further geographic controls. The third model added to the second model variables for Medicaid eligibility and ZIP-Code-level variables for income and education. All analyses were performed using SAS statistical software (version 9.1) and are reported with two-tailed P values. Our study protocol was approved by the Human Studies Committee of Harvard Medical School and the CMS Privacy Board.
Results
The demographic and socioeconomic characteristics of the enrollees who were eligible for each of the four categories of HEDIS measures during the initial and final years of measurement are shown in Table 2Table 2
Demographic Characteristics of the Study Population as Measured by HEDIS, by Year.. As compared with the proportion of white enrollees, a higher proportion of black enrollees was female, eligible for Medicaid, and living in urban areas that had higher rates of poverty and lower rates of educational attainment. Black enrollees made up a higher proportion of the sample for diabetes-related measures — a finding that probably reflects the higher prevalence of this disease among blacks. The demographic characteristics of white enrollees and black enrollees were very stable during the seven-year study period, except for an increase in the percentage of Medicaid recipients and a decrease in the percentage of white women in urban areas who were eligible for the breast-cancer-screening measure.The quality of care improved during the study period on all measures for both blacks and whites (P<0.001 for all time trends) (Table 3Table 3
Adherence to HEDIS Measures by Race and Year.). For black enrollees, the absolute improvement ranged from 6 percent (for the completion of mammography) to 43 percent (for a level of low-density lipoprotein [LDL] cholesterol <130 mg per deciliter for patients with diabetes). For white enrollees, the absolute improvement ranged from 3 percent (for completion of mammography) to 37 percent (for LDL cholesterol <130 mg per deciliter for enrollees with diabetes).The disparity between blacks and whites narrowed significantly for seven of the nine measures in the study (P<0.01). However, for control of levels of glycosylated hemoglobin, the disparity between blacks and whites increased from 4 percent to 7 percent (P<0.001). For the measure of the percentage of enrollees who achieved an LDL cholesterol level of less than 130 mg per deciliter after a myocardial infarction or a coronary procedure, racial disparities were statistically unchanged (P=0.72).
Table 4Table 4
Racial Differences in HEDIS Performance Adjusted for Demographic, Socioeconomic, and Health-Plan Effects. summarizes the results of the multivariable models. Adjustment of the HEDIS performance rates for age and sex (model 1) had little effect on estimated disparities. Additional adjustment for the enrollee's health plan and rural residence (model 2) reduced the disparities between blacks and whites in the initial and final year for six of the nine HEDIS measures and rendered the race-by-year interaction for control of glycosylated hemoglobin levels no longer statistically significant. Additional adjustment for the socioeconomic indicators of Medicaid coverage and residence in high-poverty and low-education areas (model 3) further reduced the magnitude of disparities between blacks and whites in both the initial and the final year. In all models, however, the decrease between the initial and the final year in the magnitude of disparities remained statistically significant for seven of the nine HEDIS measures we studied (P<0.01 for all race-by-year interaction terms).Figure 1Figure 1
Trends in Receipt of Two HEDIS Measures for Enrollees in Medicare Managed-Care Plans, by Race. illustrates two patterns of time trends in the quality of care for blacks and whites who were enrolled in Medicare managed care. For the testing of LDL cholesterol among enrollees with diabetes (Figure 1A), improvements for white enrollees and black enrollees were accompanied by a reduction in the racial disparity between these two groups from 1999 to 2003. In contrast, for the control in levels of LDL cholesterol below 130 mg per deciliter after a myocardial infarction or a coronary procedure (Figure 1B), clinical performance improved substantially for both white enrollees and black enrollees but with no reduction in the disparity between blacks and whites from 1999 to 2002.Discussion
In this time-trend analysis of nine clinical performance measures for enrollees in Medicare managed-care plans from 1997 to 2003, quality of care improved on all nine measures and was accompanied by a significant reduction in the disparities between blacks and whites on seven of the measures. Both trends were substantial and were not explained by changes in the sociodemographic characteristics of enrollees or in the health plans that participated in the Medicare managed-care program during the study years. In contrast, racial disparities did not decrease over time for two HEDIS measures assessing clinical outcomes for diabetes and heart disease.
An adjustment for rural residence and health plan narrowed the observed magnitude of racial disparities for most HEDIS measures — a finding suggesting that part of the racial disparity was related to the disproportionate enrollment of black beneficiaries in health plans or in regions with lower performance on these measures. Even the adjusted models, however, showed decreased racial disparities over time.
In spite of observed improvements, performance as measured by HEDIS indicators approached or exceeded 90 percent on only three measures (testing of glycosylated hemoglobin and LDL cholesterol for patients with diabetes and the frequency of prescribing beta-blockers for patients with cardiovascular disorders). On the other six measures, performance was less than 82 percent for both white enrollees and black enrollees. For these important clinical services, gaps between actual and optimal care remained substantial.2
Although racial disparities decreased to 2 percent or less for five of the six process measures, disparities remained at 7 percent or greater for the three measures assessing clinical outcomes (control of LDL cholesterol for enrollees with either diabetes or heart disease and control of glycosylated hemoglobin) in the most recent study years. Although we controlled for socioeconomic variables, the financial burden of the use of lipid-lowering and glucose-lowering medications may have contributed to the greater disparity we observed on these outcome measures, which often require sustained therapy in addition to intermittent testing.18,19
Our findings are consistent with the proposition that improvements in the quality of care are associated with reductions in racial disparities.9 By increasing the consistency of the delivery of care, interventions such as the use of reminder systems, disease management programs, and feedback to health care providers may decrease variation on the basis of nonclinical factors such as race.20-24 A greater awareness among beneficiaries or their health care providers about appropriate services for breast-cancer screening, diabetes control, and cardiovascular care could also explain our results.
We believe that the observed declines in racial disparities were unlikely to have resulted from specific health plan programs tailored to improve care for black enrollees. The representatives of nearly half of the health plans who responded to a recent survey did not collect data regarding race and ethnic background of enrollees.25 In addition, efforts by health plans to develop programs to eliminate disparities in the quality of care on the basis of racial and ethnic factors are relatively recent.26 Since late 2003, the CMS has provided data regarding enrollees' race and ethnic background to participating health plans and has required that they conduct at least one project to reduce disparities.27 However, the reduction in disparities we observed largely preceded these efforts.
The strengths of this study were the inclusion of a large, nationally representative sample of enrollees and the use of quality measures that have been audited and publicly reported by health plans for several years. Since all health plans participating in Medicare were required to report data regarding the quality of care, we avoided the selection bias associated with voluntary reporting programs.28 We were able to adjust for health plan effects and several measures of socioeconomic position that may have confounded or mediated the relationship between race and the quality of care. By limiting our primary analysis to plans with five or more consecutive years of participation in Medicare, we addressed the possibility that changes in the quality of care or reductions in disparities might be an artifact of health plans' selectively entering or exiting the Medicare program.
Our study had several limitations. It was not designed to address the factors that may have caused the observed results or to determine whether similar trends would have been observed for aspects of the quality of care beyond those assessed by the public reporting of HEDIS measures. Furthermore, patients in Medicare fee-for-service and non-Medicare settings were not included in the HEDIS data set. Previous studies have shown similar racial disparities in fee-for-service and managed-care settings,7,29 but whether our finding of decreasing racial disparities over time extends beyond Medicare managed care remains an open question.
Because enrollment data for Medicare did not reliably identify enrollees who were Hispanic, Asian, or Native American during our study years,17 we chose not to analyze trends among these ethnic and racial groups. Such studies are clearly needed. The data also lacked detailed clinical information to provide risk-adjusted outcome measures. Although unmeasured clinical factors might partially explain cross-sectional differences in outcome measures by race, such factors would be less likely to explain changes in racial disparities over time.
Several studies have suggested that racial differences in the quality and outcomes of care may be related to differences in the site of care between white and minority patients.30,31 Although we were able to analyze the contribution of health plans to racial variation in the quality of care, the current HEDIS reporting protocol does not collect information on providers and practices within plans. In addition, the attitudes of patients about health in general or about their ability to modify their diet or physical activity32,33 may contribute to racial disparities in clinical outcomes, but these variables were not available in our analysis.
Our findings have two important policy implications. For policymakers, health plan leaders, purchasers, and providers who are concerned with improving the quality of care and with reducing disparities, appropriate data are essential to gauge progress on each of these objectives. Measures of quality should be stratified by race, ethnic background, and socioeconomic position — an approach that is now rarely possible with publicly reported data on the quality of care.9,34,35 Second, although racial disparities decreased on some measures of quality, interventions that are focused on black enrollees or their health care providers may still be necessary to eliminate the disparities that remain.
In summary, improvements in the quality of care among enrollees in Medicare managed-care plans since 1997 have been accompanied by reduced racial disparities in most, but not all, measures of clinical performance we studied. Effective collaborative efforts by policymakers, health-plan administrators, clinicians, and patients may be needed to eliminate these disparities entirely.
Supported by an institutional National Research Service Award (5 T32 HP11001-15) from the Health Resources and Services Administration, by the Primary Care Research Fund of Brigham and Women's Hospital, and by a grant (P01-HS10803) from the Agency for Healthcare Research and Quality.
We are indebted to Robert E. Wolf and Matthew Cioffi for statistical and programming contributions; to Kimberly Elmo and Judy Giles for help with data acquisition; and to the Research Data Assistance Center at the University of Minnesota.
Source Information
From the Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital (A.N.T., E.C.S., J.Z.A.); the Department of Health Care Policy, Harvard Medical School (A.N.T., A.M.Z., J.Z.A.); and the Department of Health Policy and Management, Harvard School of Public Health (E.C.S., J.Z.A.) — all in Boston.
Address reprint requests to Dr. Ayanian at the Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, or at ayanian@hcp.med.harvard.edu.
- References
References
1
Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, D.C.: National Academy Press, 2001.
2
McGlynn EA ,Asch SM ,Adams J , et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348:2635-2645
Full Text | Web of Science | Medline3
Jencks SF ,Cuerdon T ,Burwen DR , et al. Quality of care delivered to Medicare beneficiaries: a profile at state and national levels. JAMA 2000;284:1670-1676
CrossRef | Web of Science | Medline4
Smedley BD, Stith AY, Nelson AR, eds. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, D.C.: National Academy Press, 2003.
5
Ayanian JZ ,Weissman JS ,Chasan-Taber S ,Epstein AM . Quality of care by race and gender for congestive heart failure and pneumonia. Med Care 1999;37:1260-1269
CrossRef | Web of Science | Medline6
Schneider EC ,Zaslavsky AM ,Epstein AM . Racial disparities in the quality of care for enrollees in Medicare managed care. JAMA 2002;287:1288-1294
CrossRef | Web of Science | Medline7
Schneider EC ,Cleary PD ,Zaslavsky AM ,Epstein AM . Racial disparity in influenza vaccination: does managed care narrow the gap between African Americans and whites? JAMA 2001;286:1455-1460
CrossRef | Web of Science | Medline8
Virnig BA ,Lurie N ,Huang Z ,Musgrave D ,McBean AM ,Dowd B . Racial variation in quality of care among Medicare + Choice enrollees. Health Aff (Millwood) 2002;21:224-230
CrossRef | Web of Science | Medline9
Fiscella K ,Franks P ,Gold MR ,Clancy CM . Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA 2000;283:2579-2584
CrossRef | Web of Science | Medline10
Jencks SF ,Huff ED ,Cuerdon T . Change in the quality of care delivered to Medicare beneficiaries, 1998-1999 to 2000-2001. JAMA 2003;289:305-312[Erratum, JAMA 2003;289:2649.]
CrossRef | Web of Science | Medline11
Lied TR ,Sheingold S . HEDIS performance trends in Medicare managed care. Health Care Financ Rev 2001;23:149-160
Web of Science | Medline12
Jha AK ,Perlin JB ,Kizer KW ,Dudley RA . Effect of the transformation of the Veterans Affairs health care system on the quality of care. N Engl J Med 2003;348:2218-2227
Full Text | Web of Science | Medline13
Sehgal AR . Impact of quality improvement efforts on race and sex disparities in hemodialysis. JAMA 2003;289:996-1000
CrossRef | Web of Science | Medline14
Baker LC ,Hopkins D ,Dixon R ,Rideout J ,Geppert J . Do health plans influence quality of care? Int J Qual Health Care 2004;16:19-30
CrossRef | Web of Science | Medline15
Zaslavsky AM, Ayanian JZ. Integrating research on racial and ethnic disparities in health care over place and time. Med Care 2005;43:303-7.
16
Health Care Financing Administration. Medicare HEDIS3.0/1998 data audit report. (Accessed July 22, 2005, at http://permanent.access.gpo.gov/websites/www.hcfa.gov/quality/3i2.htm.)
17
Arday SL ,Arday DR ,Monroe S ,Zhang J . HCFA's racial and ethnic data: current accuracy and recent improvements. Health Care Financ Rev 2000;21:107-116
Web of Science | Medline18
Federman AD ,Adams AS ,Ross-Degnan D ,Soumerai SB ,Ayanian JZ . Supplemental insurance and use of effective cardiovascular drugs among elderly Medicare beneficiaries with coronary heart disease. JAMA 2001;286:1732-1739
CrossRef | Web of Science | Medline19
Persell SD ,Maviglia SM ,Bates DW ,Ayanian JZ . Ambulatory hypercholesterolemia management in patients with atherosclerosis: gender and race differences in processes and outcomes. J Gen Intern Med 2005;20:123-130
CrossRef | Web of Science | Medline20
Kiefe CI ,Allison JJ ,Williams OD ,Person SD ,Weaver MT ,Weissman NW . Improving quality improvement using achievable benchmarks for physician feedback: a randomized controlled trial. JAMA 2001;285:2871-2879
CrossRef | Web of Science | Medline21
Bates DW ,Leape LL ,Cullen DJ , et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998;280:1311-1316
CrossRef | Web of Science | Medline22
Grimshaw J ,McAuley LM ,Bero LA , et al. Systematic reviews of the effectiveness of quality improvement strategies and programmes. Qual Saf Health Care 2003;12:298-303
CrossRef | Web of Science | Medline23
Weingarten SR ,Henning JM ,Badamgarav E , et al. Interventions used in disease management programmes for patients with chronic illness -- which ones work? Meta-analysis of published reports. BMJ 2002;325:925-933
CrossRef | Web of Science | Medline24
Weiner M ,Callahan CM ,Tierney WM , et al. Using information technology to improve the health care of older adults. Ann Intern Med 2003;139:430-436
Web of Science | Medline25
America's Health Insurance Plans and The Robert Wood Johnson Foundation. Collection of racial and ethnic data by health plans to address disparities: final summary report. (Accessed July 22, 2005, at http://www.rwjf.org/files/research/080504AHIPFinalSummary.pdf.)
26
Hassett P . Taking on racial and ethnic disparities in health care: the experience at Aetna. Health Aff (Millwood) 2005;24:417-420
CrossRef | Web of Science | Medline27
Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, § 1852.
28
McCormick D ,Himmelstein DU ,Woolhandler S ,Wolfe SM ,Bor DH . Relationship between low quality-of-care scores and HMOs' subsequent public disclosure of quality-of-care scores. JAMA 2002;288:1484-1490
CrossRef | Web of Science | Medline29
DeLaet DE ,Shea S ,Carrasquillo O . Receipt of preventive services among privately insured minorities in managed care versus fee-for-service insurance plans. J Gen Intern Med 2002;17:451-457
CrossRef | Web of Science | Medline30
Bach PB ,Pham HH ,Schrag D ,Tate RC ,Hargraves JL . Primary care physicians who treat blacks and whites. N Engl J Med 2004;351:575-584
Full Text | Web of Science | Medline31
Bradley EH ,Herrin J ,Wang Y , et al. Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA 2004;292:1563-1572
CrossRef | Web of Science | Medline32
Ayanian JZ ,Landrum MB ,McNeil BJ . Use of cholesterol-lowering therapy by elderly adults after myocardial infarction. Arch Intern Med 2002;162:1013-1019
CrossRef | Web of Science | Medline33
Persell SD ,Keating NL ,Landrum MB , et al. Relationship of diabetes-specific knowledge to self-management activities, ambulatory preventive care, and metabolic outcomes. Prev Med 2004;39:746-752
CrossRef | Web of Science | Medline34
Ver Ploeg M, Perrin E, eds. Eliminating health disparities: measurement and data needs. Washington, D.C.: National Academies Press, 2004.
35
Zaslavsky AM ,Hochheimer JN ,Schneider EC , et al. Impact of sociodemographic case mix on the HEDIS measures of health plan quality. Med Care 2000;38:981-992
CrossRef | Web of Science | Medline
- Citing Articles (91)
Citing Articles
1
Samuel T. Savitz. (2012) Literature-Based Appraisal of Racial/Ethnic Cardiovascular Health Care Disparities. ISRN Public Health 2012, 1-7
CrossRef2
Robin J Casten, Rickie Brawer, Jullia A Haller, Lisa A Hark, Jeffrey Henderer, Benjamin Leiby, Ann P Murchison, James Plumb, Barry W Rovner, David M Weiss. (2011) Trial of a behavioral intervention to increase dilated fundus examinations in African–Americans aged over 65 years with diabetes. Expert Review of Ophthalmology 6:6, 593-601
CrossRef3
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
CrossRef4
Ashish K. Jha, Arnold M. Epstein. (2011) Governance Around Quality of Care at Hospitals that Disproportionately Care for Black Patients. Journal of General Internal Medicine
CrossRef5
Jayasree Basu. (2011) Medicare managed care and primary care quality: examining racial/ethnic effects across states. Health Care Management Science
CrossRef6
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
CrossRef7
Ran D. Balicer, Efrat Shadmi, Nicky Lieberman, Sari Greenberg-Dotan, Margalit Goldfracht, Liora Jana, Arnon D. Cohen, Sigal Regev-Rosenberg, Orit Jacobson. (2011) Reducing Health Disparities: Strategy Planning and Implementation in Israel's Largest Health Care Organization. Health Services Research 46:4, 1281-1299
CrossRef8
Marc N. Elliott, Amelia M. Haviland, Nate Orr, Katrin Hambarsoomian, Paul D. Cleary. (2011) How Do the Experiences of Medicare Beneficiary Subgroups Differ between Managed Care and Original Medicare?. Health Services Research 46:4, 1039-1058
CrossRef9
B. J. Berkman. (2011) Seizing Interdisciplinary Opportunities in the Changing Landscape of Health and Aging: A Social Work Perspective. The Gerontologist 51:4, 433-440
CrossRef10
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
CrossRef11
Zhen Zhao. (2011) Power of tests for comparing trend curves with application to national immunization survey (NIS). Statistics in Medicinen/a-n/a
CrossRef12
S. Patel, V.K. Rajput. (2011) Do hospitals provide lower quality of care to black patients for pneumonia?. Yearbook of Critical Care Medicine 2011, 289-291
CrossRef13
Patrick Richard, Pierre Kébreau Alexandre, Mustafa Zeedan Younis, Anthony Lara, Adaeze B. Akamigbo. (2010) Racial and Ethnic Disparities in the Quality of Diabetes Care for the Elderly in a Nationally Representative Sample. Ageing International
CrossRef14
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
CrossRef15
Jun Tomio, Satoshi Toyokawa, Shinichi Tanihara, Kazuo Inoue, Yasuki Kobayashi. (2010) Quality of care for diabetes patients using National Health Insurance claims data in Japan. Journal of Evaluation in Clinical Practice 16:6, 1164-1169
CrossRef16
Juliana Chan, Hairong Nan, Rose Ting. 2010. Depression and Diabetes: Sociodemographic and Cultural Aspects and Public Health Implications. , 143-171.
CrossRef17
Kimlin T. Ashing-Giwa, Jung-Won Lim. (2010) Predicting physical quality of life among a multiethnic sample of breast cancer survivors. Quality of Life Research 19:6, 789-802
CrossRef18
Stefan A. Baeten, Rob M.P.M. Baltussen, Carin A. Uyl-de Groot, John Bridges, Louis W. Niessen. (2010) Incorporating Equity–Efficiency Interactions in Cost-Effectiveness Analysis—Three Approaches Applied to Breast Cancer Control. Value in Health 13:5, 573-579
CrossRef19
Gabriela Schmajuk, Edward Yelin, Eliza Chakravarty, Lorene M. Nelson, Pantelis Panopolis, Jinoos Yazdany. (2010) Osteoporosis screening, prevention, and treatment in systemic lupus erythematosus: application of the systemic lupus erythematosus quality indicators. Arthritis Care & Research 62:7, 993-1001
CrossRef20
A. Verma, R. Birger, H. Bhatt, J. Murray, C. Millett, S. Saxena, R. Banarsee, S. Gnani, A. Majeed. (2010) Ethnic disparities in diabetes management: a 10-year population-based repeated cross-sectional study in UK primary care. Journal of Public Health 32:2, 250-258
CrossRef21
Jawahar L. Mehta, Zoran Bursac, Paulette Mehta, Darpan Bansal, Louis Fink, James Marsh, Rishi Sukhija, Rajesh Sachdeva. (2010) Racial Disparities in Prescriptions for Cardioprotective Drugs and Cardiac Outcomes in Veterans Affairs Hospitals. The American Journal of Cardiology 105:7, 1019-1023
CrossRef22
Rhys G. Jones, Amal N. Trivedi, John Z. Ayanian. (2010) Factors influencing the effectiveness of interventions to reduce racial and ethnic disparities in health care. Social Science & Medicine 70:3, 337-341
CrossRef23
Trivedi, Amal N., Moloo, Husein, Mor, Vincent, . (2010) Increased Ambulatory Care Copayments and Hospitalizations among the Elderly. New England Journal of Medicine 362:4, 320-328
Full Text24
Bruce H. Wade, Jack H. Stone. (2010) Overcoming Disciplinary and Institutional Barriers: An Interdisciplinary Course in Economic and Sociological Perspectives on Health Issues. The Journal of Economic Education 41:1, 71-84
CrossRef25
Tracy Onega, Eric J. Duell, Xun Shi, Eugene Demidenko, David C. Goodman. (2010) Race versus place of service in mortality among Medicare beneficiaries with cancer. CancerNA-NA
CrossRef26
Derek D. Satre, Cynthia I. Campbell, Nancy P. Gordon, Constance Weisner. (2010) Ethnic Disparities in Accessing Treatment for Depression and Substance Use Disorders in an Integrated Health Plan. The International Journal of Psychiatry in Medicine 40:1, 57-76
CrossRef27
Marcela Horvitz-Lennon, Thomas G. McGuire, Margarita Alegria, Richard G. Frank. (2009) Racial and Ethnic Disparities in the Treatment of a Medicaid Population with Schizophrenia. Health Services Research 44:6, 2106-2122
CrossRef28
David Ansell, Paula Grabler, Steven Whitman, Carol Ferrans, Jacqueline Burgess-Bishop, Linda Rae Murray, Ruta Rao, Elizabeth Marcus. (2009) A community effort to reduce the black/white breast cancer mortality disparity in Chicago. Cancer Causes & Control 20:9, 1681-1688
CrossRef29
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
CrossRef30
Matthew L. Maciejewski, Sarah Birken, Mark Perkins, James F. Burgess, Nancy Sharp, Chuan-Fen Liu. (2009) Medicare Managed Care Enrollment by Disability-Eligible and Age-Eligible Veterans. Medical Care 47:11, 1180-1185
CrossRef31
Esi Morgan DeWitt, Li Lin, Henry A. Glick, Kevin J. Anstrom, Kevin A. Schulman, Shelby D. Reed. (2009) Pattern and predictors of the initiation of biologic agents for the treatment of rheumatoid arthritis in the United States: An analysis using a large observational data bank. Clinical Therapeutics 31:8, 1871-1880
CrossRef32
Patricia S. Keenan, Marc N. Elliott, Paul D. Cleary, Alan M. Zaslavsky, Bruce E. Landon. (2009) Quality Assessments by Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care. Medical Care 47:8, 882-888
CrossRef33
O Kenrik Duru, Robert B. Gerzoff, Joseph V. Selby, Arleen F. Brown, Ronald T. Ackermann, Andrew J. Karter, Sonja Ross, W Neil Steers, William H. Herman, Beth Waitzfelder, Carol M. Mangione. (2009) Identifying Risk Factors for Racial Disparities in Diabetes Outcomes. Medical Care 47:6, 700-706
CrossRef34
Stephen G. Sawada, Samer Sayyed, Azad Raiesdana, Irmina Gradus-Pizlo, Jothiharan Mahenthiran, Harvey Feigenbaum. (2009) Clinical Assessment and Rest and Stress Echocardiography for Prediction of Long-Term Prognosis in African Americans with Known or Suspected Coronary Artery Disease. Echocardiography 26:5, 558-566
CrossRef35
Koon-Hou Mak, Deepak L. Bhatt, Mingyuan Shao, Graeme J. Hankey, J. Donald Easton, Keith A.A. Fox, Eric J. Topol. (2009) Ethnic variation in adverse cardiovascular outcomes and bleeding complications in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) study. American Heart Journal 157:4, 658-665
CrossRef36
Joshua J. Fenton, Daniel J. Tancredi, Pamela Green, Peter Franks, Laura-Mae Baldwin. (2009) Persistent Racial and Ethnic Disparities in Up-to-Date Colorectal Cancer Testing in Medicare Enrollees. Journal of the American Geriatrics Society 57:3, 412-418
CrossRef37
Nicholas J. Hellenthal, Karim Chamie, Michelle L. Ramirez, Ralph W. deVere White. (2009) Sociodemographic Factors Associated With Nephrectomy in Patients With Metastatic Renal Cell Carcinoma. The Journal of Urology 181:3, 1013-1019
CrossRef38
Usha Subramanian, Ronald T. Ackermann, Edward J. Brizendine, Chandan Saha, Marc B. Rosenman, Deanna R. Willis, David G. Marrero. (2009) Effect of Advanced Access Scheduling on Processes and Intermediate Outcomes of Diabetes Care and Utilization. Journal of General Internal Medicine 24:3, 327-333
CrossRef39
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
CrossRef40
A. J. Bleyer, D. Hire, G. B. Russell, J. Xu, J. Divers, Z. Shihabi, D. W. Bowden, B. I. Freedman. (2009) Ethnic variation in the correlation between random serum glucose concentration and glycated haemoglobin. Diabetic Medicine 26:2, 128-133
CrossRef41
Hye-Sun Ro, Richard S. Wampler. (2009) What’s Wrong With These People? Clinicians’ Views of Clinical Couples. Journal of Marital and Family Therapy 35:1, 3-17
CrossRef42
Thomas D. Sequist, Eric C. Schneider, Michael Anastario, Esosa G. Odigie, Richard Marshall, William H. Rogers, Dana Gelb Safran. (2008) Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes. Journal of General Internal Medicine 23:11, 1784-1790
CrossRef43
Ellen B. Fung, Paul R. Harmatz, Meredith Milet, Vinod Balasa, Samir K. Ballas, James F. Casella, Lee Hilliard, Abdullah Kutlar, Kenneth L. McClain, Nancy F. Olivieri, John B. Porter, Elliott P. Vichinsky, . (2008) Disparity in the management of iron overload between patients with sickle cell disease and thalassemia who received transfusions. Transfusion 48:9, 1971-1980
CrossRef44
Dana B. Mukamel, David L. Weimer, William D. Spector, Heather Ladd, Jacqueline S. Zinn. (2008) Publication of Quality Report Cards and Trends in Reported Quality Measures in Nursing Homes. Health Services Research 43:4, 1244-1262
CrossRef45
B. R. Shah. (2008) Utilization of physician services for diabetic patients from ethnic minorities. Journal of Public Health 30:3, 327-331
CrossRef46
L Elizabeth Goldman, Sebastien J.-P. A. Haneuse, Diana L. Miglioretti, Karla Kerlikowske, Diana S. M. Buist, Bonnie Yankaskas, Rebecca Smith-Bindman. (2008) An Assessment of the Quality of Mammography Care at Facilities Treating Medically Vulnerable Populations. Medical Care 46:7, 701-708
CrossRef47
Irena Stepanikova, Karen S. Cook. (2008) Effects of Poverty and Lack of Insurance on Perceptions of Racial and Ethnic Bias in Health Care. Health Services Research 43:3, 915-930
CrossRef48
Peter Franks, Kevin Fiscella. (2008) Reducing Disparities Downstream: Prospects and Challenges. Journal of General Internal Medicine 23:5, 672-677
CrossRef49
Thomas D. Sequist, John Z. Ayanian, Richard Marshall, Garret M. Fitzmaurice, Dana Gelb Safran. (2008) Primary-care Clinician Perceptions of Racial Disparities in Diabetes Care. Journal of General Internal Medicine 23:5, 678-684
CrossRef50
Leonard E. Egede, Hayden Bosworth. (2008) The Future of Health Disparities Research: 2008 and Beyond. Journal of General Internal Medicine 23:5, 706-708
CrossRef51
John Z. Ayanian. (2008) Determinants of Racial and Ethnic Disparities in Surgical Care. World Journal of Surgery 32:4, 509-515
CrossRef52
Renee Y. Hsia, Donna MacIsaac, Erin Palm, Laurence C. Baker. (2008) Trends in Charges and Payments for Nonhospitalized Emergency Department Pediatric Visits, 1996–2003. Academic Emergency Medicine 15:4, 347-354
CrossRef53
ERROL D. CROOK, MOSHA PETERS. (2008) Health Disparities in Chronic Diseases: Where the Money Is. The American Journal of the Medical Sciences 335:4, 266-270
CrossRef54
Luigi Meneghini. (2008) Ethnic disparities in diabetes care: myth or reality?. Current Opinion in Endocrinology, Diabetes and Obesity 15:2, 128-134
CrossRef55
Jean Yoon, Jennifer L. Malin, Diana M. Tisnado, May Lin Tao, John L. Adams, Martha J. Timmer, Patricia A. Ganz, Katherine L. Kahn. (2008) Symptom management after breast cancer treatment: is it influenced by patient characteristics?. Breast Cancer Research and Treatment 108:1, 69-77
CrossRef56
Cary P. Gross, Benjamin D. Smith, Elizabeth Wolf, Martin Andersen. (2008) Racial disparities in cancer therapy. Cancer 112:4, 900-908
CrossRef57
Trivedi, Amal N., Rakowski, William, Ayanian, John Z., . (2008) Effect of Cost Sharing on Screening Mammography in Medicare Health Plans. New England Journal of Medicine 358:4, 375-383
Full Text58
Nina A. Bickell, Alicia Cohen. (2008) Understanding reasons for underuse: An approach to improve quality and reduce disparities in breast cancer treatmentrr. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 75:1, 23-30
CrossRef59
Carol R. Horowitz, Judith Z. Goldfinger, Sara E. Muller, Romina S. Pulichino, Thomas L. Vance, Guedy Arniella, Kristie J. Lancaster. (2008) A model for using community-based participatory research to address the diabetes epidemic in east harlem. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 75:1, 13-21
CrossRef60
Alain G. Bertoni, Jeanne M. Clark, Patricia Feeney, Susan Z. Yanovski, John Bantle, Brenda Montgomery, Monika M. Safford, William H. Herman, Steven Haffner. (2008) Suboptimal control of glycemia, blood pressure, and LDL cholesterol in overweight adults with diabetes: the Look AHEAD Study. Journal of Diabetes and its Complications 22:1, 1-9
CrossRef61
S. Keyhani, J. S. Ross, P. Hebert, C. Dellenbaugh, J. D. Penrod, A. L. Siu. (2007) Use of Preventive Care by Elderly Male Veterans Receiving Care Through the Veterans Health Administration, Medicare Fee-for-Service, and Medicare HMO Plans. American Journal of Public Health 97:12, 2179-2185
CrossRef62
Walid F. Gellad, Jennifer S. Haas, Dana Gelb Safran. (2007) Race/Ethnicity and Nonadherence to Prescription Medications Among Seniors: Results of a National Study. Journal of General Internal Medicine 22:11, 1572-1578
CrossRef63
Lisa B. Caruso, Kerri M. Clough-Gorr, Rebecca A. Silliman. (2007) Improving Quality of Care for Urban Older People with Diabetes Mellitus and Cardiovascular Disease. Journal of the American Geriatrics Society 55:10, 1656-1662
CrossRef64
Jeremy Gray, Christopher Millett, Sonia Saxena, Gopalakrishnan Netuveli, Kamlesh Khunti, Azeem Majeed. (2007) Ethnicity and Quality of Diabetes Care in a Health System with Universal Coverage: Population-Based Cross-sectional Survey in Primary Care. Journal of General Internal Medicine 22:9, 1317-1320
CrossRef65
Elizabeth B. Habermann, Beth A. Virnig, Gerald F. Riley, Nancy N. Baxter. (2007) The Impact of a Change in Medicare Reimbursement Policy and HEDIS Measures on Stage at Diagnosis Among Medicare HMO and Fee-For-Service Female Breast Cancer Patients. Medical Care 45:8, 761-766
CrossRef66
Stephen O’Mahony, Eric Mazur, Pamela Charney, Yun Wang, Jonathan Fine. (2007) Use of Multidisciplinary Rounds to Simultaneously Improve Quality Outcomes, Enhance Resident Education, and Shorten Length of Stay. Journal of General Internal Medicine 22:8, 1073-1079
CrossRef67
K. L. Kahn, C. H. MacLean, A. L. Wong, L. Z. Rubenstein, H. Liu, D. M. Fitzpatrick, J. O. Harker, W. P. Chen, S. B. Traina, B. S. Mittman, B. H. Hahn, H. E. Paulus. (2007) Assessment of American College of Rheumatology quality criteria for rheumatoid arthritis in a pre–quality criteria patient cohort. Arthritis & Rheumatism 57:5, 707-715
CrossRef68
Sande O. Okelo, Albert W. Wu, Barry Merriman, Jerry A. Krishnan, Gregory B. Diette. (2007) Are Physician Estimates of Asthma Severity Less Accurate in Black than in White Patients?. Journal of General Internal Medicine 22:7, 976-981
CrossRef69
Derek M. Griffith, Mondi Mason, Michael Yonas, Eugenia Eng, Vanessa Jeffries, Suzanne Plihcik, Barton Parks. (2007) Dismantling institutional racism: theory and action. American Journal of Community Psychology 39:3-4, 381-392
CrossRef70
Carter R. Coberley, Gary A. Puckrein, Angela C. Dobbs, Matthew A. McGinnis, Sadie S. Coberley, Dexter W. Shurney. (2007) Effectiveness of Disease Management Programs on Improving Diabetes Care for Individuals in Health-Disparate Areas. Disease Management 10:3, 147-155
CrossRef71
Robert L. Kane, Timothy Wilt, Maria E. Suarez-almazor, Steven S. Fu. (2007) Disparities in total knee replacements: A review. Arthritis & Rheumatism 57:4, 562-567
CrossRef72
Ann F. Chou, Arleen F. Brown, Roxanne E. Jensen, Sarah Shih, Greg Pawlson, Sarah Hudson Scholle. (2007) Gender and Racial Disparities in the Management of Diabetes Mellitus Among Medicare Patients. Women's Health Issues 17:3, 150-161
CrossRef73
Chloe E. Bird, Allen M. Fremont, Arlene S. Bierman, Steve Wickstrom, Mona Shah, Thomas Rector, Thomas Horstman, José J. Escarce. (2007) Does Quality of Care for Cardiovascular Disease and Diabetes Differ by Gender for Enrollees in Managed Care Plans?. Women's Health Issues 17:3, 131-138
CrossRef74
Kenneth J. Mukamal. (2007) Impact of Race and Ethnicity on Counseling for Alcohol Consumption: A Population-Based, Cross-Sectional Survey. Alcoholism: Clinical and Experimental Research 31:3, 452-457
CrossRef75
Landon, Bruce E., Hicks, LeRoi S., O'Malley, A. James, Lieu, Tracy A., Keegan, Thomas, McNeil, Barbara J., Guadagnoli, Edward, . (2007) Improving the Management of Chronic Disease at Community Health Centers. New England Journal of Medicine 356:9, 921-934
Full Text76
C. Kayhan, M. Daffertshofer, O. Mielke, M. Hennerici, S. Schwarz. (2007) Vergleich deutscher und türkischer Patienten mit ischämischem Schlaganfall. Der Nervenarzt 78:2, 188-192
CrossRef77
Ellen Wagenfeld-Heintz, Victoria C. Ross, Keon-Hyung Lee. (2007) Physicians' Perceptions of Patients in a County Sponsored Health Plan. Social Work in Public Health 23:1, 45-59
CrossRef78
Daniel P. Schauer, Joseph A. Johnston, Charles J. Moomaw, Mark Wess, Mark H. Eckman. (2007) Racial Disparities in the Filling of Warfarin Prescriptions for Nonvalvular Atrial Fibrillation. The American Journal of the Medical Sciences 333:2, 67-73
CrossRef79
Christopher Millett, Jeremy Gray, Sonia Saxena, Gopalakrishnan Netuveli, Kamlesh Khunti, Azeem Majeed. (2007) Ethnic Disparities in Diabetes Management and Pay-for-Performance in the UK: The Wandsworth Prospective Diabetes Study. PLoS Medicine 4:6, e191
CrossRef80
O Kenrik Duru, Carol M. Mangione, Neil W. Steers, William H. Herman, Andrew J. Karter, David Kountz, David G. Marrero, Monika M. Safford, Beth Waitzfelder, Robert B. Gerzoff, Soonim Huh, Arleen F. Brown. (2006) The Association Between Clinical Care Strategies and the Attenuation of Racial/Ethnic Disparities in Diabetes Care. Medical Care 44:12, 1121-1128
CrossRef81
Jennifer J. Manly. (2006) Deconstructing Race and Ethnicity. Medical Care 44:Suppl 3, S10-S16
CrossRef82
F. Sassi, H. S. Luft, E. Guadagnoli. (2006) Reducing Racial/Ethnic Disparities in Female Breast Cancer: Screening Rates and Stage at Diagnosis. American Journal of Public Health 96:12, 2165-2172
CrossRef83
Sunil Kripalani, Jada Bussey-Jones, Marra G. Katz, Inginia Genao. (2006) A Prescription for Cultural Competence in Medical Education. Journal of General Internal Medicine 21:10, 1116-1120
CrossRef84
Mark R. Cullen, Sally Vegso, Linda Cantley, Deron Galusha, Peter Rabinowitz, Oyebode Taiwo, Martha Fiellin, David Wennberg, Joanne Iennaco, Martin D. Slade, Kanta Sircar. (2006) Use of Medical Insurance Claims Data for Occupational Health Research. Journal of Occupational and Environmental Medicine 48:10, 1054-1061
CrossRef85
Thomas D. Sequist, Eric C. Schneider. (2006) Addressing Racial and Ethnic Disparities in Health Care: Using Federal Data to Support Local Programs to Eliminate Disparities. Health Services Research 0:0, 060720074824038-???
CrossRef86
Iris I. Wei, Beth A. Virnig, Dolly A. John, Robert O. Morgan. (2006) Using a Spanish Surname Match to Improve Identification of Hispanic Women in Medicare Administrative Data. Health Services Research 0:0, 060720074824041-???
CrossRef87
Peter Davis, Roy Lay-Yee, Lorna Dyall, Robin Briant, Andrew Sporle, Deborah Brunt, Alastair Scott. (2006) Quality of hospital care for Māori patients in New Zealand: retrospective cross-sectional assessment. The Lancet 367:9526, 1920-1925
CrossRef88
Lisa I Iezzoni. (2006) Quality of care for Medicare beneficiaries with disabilities under the age of 65 years. Expert Review of Pharmacoeconomics & Outcomes Research 6:3, 261-273
CrossRef89
Jewell H. Halanych, Fei Wang, Donald R. Miller, Leonard M. Pogach, Hai Lin, Dan R. Berlowitz, Susan M. Frayne. (2006) Racial/Ethnic Differences in Diabetes Care for Older Veterans. Medical Care 44:5, 439-445
CrossRef90
(2005) Trends in Racial Disparities in Care. New England Journal of Medicine 353:19, 2081-2085
Full Text91
Lurie, Nicole, . (2005) Health Disparities — Less Talk, More Action. New England Journal of Medicine 353:7, 727-729
Full Text
- Letters
