Abstract:
CONTEXT:Treatment disparities for socioeconomically disadvantaged populations have been widely reported, but few studies have sought explanations for these disparities. OBJECTIVE:To compare the quality of care for patients insured by Medicare alone, Medicare plus Medicaid, or Medicare plus private insurance and investigate mediators for potential disparities. DESIGN, SETTING, AND PARTICIPANTS:Retrospective, random chart review of 3122 African American or White Medicare patients >65 years of age hospitalized for unstable angina in 22 Alabama hospitals, 1993-1999. MAIN OUTCOME MEASURES:Echocardiogram within 20 minutes of presentation; evaluation by a cardiologist; appropriate anti-platelet therapy within 24 hours of admission and at discharge, heparin for high-risk patients, beta-blockers during hospitalization, and performance of appropriate coronary angiography. RESULTS:182 (5.8%) had Medicare only, 433 (13.9%) had Medicare plus Medicaid, and 2507 (80.3%) had Medicare plus private insurance. Medicaid patients were more frequently Black, female, >85 years old, had multiple co-morbidities, or were admitted to hospitals without cardiac catheterization facilities (P<.001). Fewer Medicaid patients were admitted to hospitals with cardiac catheterization capabilities. Even after adjustment for demographics and hospital characteristics, Medicaid patients were less likely to see a cardiologist (odds ratio [OR] .57, 95% confidence interval [CI] .44-.73), receive antiplatelet therapy within 24 hours of admission (OR .66, 95% CI .50-.87), or heparin (OR .71, 95% CI .53-.97). No differences were seen with regard to having an electrocardiogram within 20 minutes of admission. Beta-blockers were used least in the Medicare-only patients, with only 37.7% receiving them (P=.04). Suitable Medicaid patients received coronary angiography less often, even after adjustment for demographics, co-morbidity, and prior revascularization (OR .68, 95% CI .48-.97). However, when adjusted for hospital characteristics, this finding was no longer observed (OR .94, 95% CI .64-1.39). CONCLUSIONS:Elderly Medicaid patients appear to receive poorer quality of care. This finding is partially, but not completely, explained by characteristics of the facilities where they are hospitalized.
journal_name
Ethn Disjournal_title
Ethnicity & diseaseauthors
Pamboukian SV,Funkhouser E,Child IG,Allison JJ,Weissman NW,Kiefe CIsubject
Has Abstractpub_date
2006-10-01 00:00:00pages
799-807issue
4eissn
1049-510Xissn
1945-0826journal_volume
16pub_type
杂志文章,多中心研究abstract:OBJECTIVE:Little is known about the health outcomes or the quality of care among Arab American patients with diabetes. The objective of this study is to examine the use of glucose-lowering agents and aspirin therapy in this population compared to the drug utilization patterns reported in nationally representative surve...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:To examine the adequacy of available evidence that: 1) left ventricular hypertrophy (LVH) and its regression influence the rate of cardiovascular events in hypertension; 2) carotid artery wall thickening and discrete plaque have comparable significance to LVH; and 3) black hypertensive patients have greater ...
journal_title:Ethnicity & disease
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:This study examines the cancer prevention and control priorities of uninsured Latin Americans and their primary care providers in metropolitan Washington, D.C. Patient and provider priorities are compared to identify common ground for future interventions in resource constrained primary care settings. METHOD...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:To describe older African Americans' communication with pharmacists and their opinions, beliefs, perceptions, and attitudes about the role of the community pharmacist. DESIGN:We conducted six sex-specific focus groups for this qualitative study. SETTING:Community-based senior-serving agency located in a pre...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract::C-reactive protein (CRP) is a risk factor for cardiovascular disease and mortality; it is known to be positively associated with obesity but there is some evidence that this association differs by race or sex. We used nationally representative data of adults aged >50 years to investigate sex and race modifiers of the ...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:10.18865/ed.26.2.197
更新日期:2016-04-21 00:00:00
abstract:OBJECTIVE:Our study aimed to assess patient's perceptions of generic drugs and utilization of generic drug discount programs. DESIGN, SETTING AND PARTICIPANTS:A survey was administered to adult participants at community health centers and community-based organizations in Houston, Texas, USA (n=525). MAIN OUTCOME MEAS...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To determine dietary intake and attitude toward weight control of normal weight, overweight, and obese Black women. DESIGN:Cross-sectional survey. SETTING:Rural village in KwaZulu province, South Africa. PARTICIPANTS:A convenience sample (N=187) of 25- to 55-year-old women, of whom 28.9% (N=54) were of no...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2005-04-01 00:00:00
abstract::There are well-known Black-White disparities in adverse birth outcomes, health behaviors, and chronic diseases such as asthma, diabetes, and hypertension. These disparities hold across socioeconomic status and have remained stable for the past 50 years despite efforts to reduce them. This theoretical review argues tha...
journal_title:Ethnicity & disease
pub_type: 杂志文章,评审
doi:
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To examine the utilization of health services and prescription patterns among patients with systemic lupus erythematosus (SLE) followed by primary care physicians and rheumatologists in Puerto Rico. METHODS:The insurance claims submitted by physicians to a health insurance company of Puerto Rico in 2003 were...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2008-04-01 00:00:00
abstract::The concept of acquired immune deficiency syndrome (AIDS) as a behavioral problem, and the emphasis placed by researchers on race and ethnicity as "risk factors," have led to research focused on the "risk behaviors" of historically oppressed groups and a continuing social policy thrust that "blames the victim." Dispro...
journal_title:Ethnicity & disease
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:HIV+ mothers of adolescent girls can serve as agents of change, particularly when it comes to preventing patterns of behaviors that are inherently dangerous. In order to do so these women need to be able to communicate with their daughters and educate them about risk behaviors, especially those associated wi...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract::The purpose of the present study was to examine variation in heart disease death rates by the social class of decedents. The term, "social class" refers to a complex set of phenomena such as control over economic resources, social status, and power relative to others in society. The target population for this study wa...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:While high caffeine consumption has been shown to be associated with increased blood pressure in controlled experiments, the relationship between caffeine consumption and blood pressure in preadolescent (ages 6-11 years) and adolescent (ages 12-19 years) children has not been well studied. The primary object...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2008-07-01 00:00:00
abstract:Background and Purpose:Blacks have a higher burden of post-stroke disability. Factors associated with racial differences in long-term post-stroke disability are not well-understood. Our aim was to assess the long-term racial differences in risk factors associated with stroke recovery. Methods:We examined Health and Re...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:10.18865/ed.30.2.339
更新日期:2020-04-23 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine (1) how African-American and white men and women from similar low income communities perceive their body mass relative to others in the population; and (2) whether ethnic and gender differences exist in the selection of ideal body image sizes for the same and opposit...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:Relationships among sedentary behavior, weight gain, and weight loss and regain are understudied particularly for African Americans, a high risk group for obesity. The hypotheses were: sedentary behavior is positively associated with current body mass and % of weight loss maintained after initial weight loss...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract::Stroke continues to kill disproportionately more Blacks and Hispanics than Whites in the United States. Racial/ethnic variations in the incidence of stroke and prevalence of stroke risk factors are probably explained by both genetic and environmental influences. Family studies can help identify genetic predisposition ...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Approximately 20 million adults suffer from depressive illnesses each year and women are at least twice as likely as men to experience depressive disorders and symptoms. Empirical results have been mixed regarding racial differences in depression prevalence. Given that depression has negative effects on mate...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To assess the impact of African American race on hypertension management among a real-world hypertensive population. DESIGN:Cross-sectional study. SETTING:28 US physician practices. PATIENTS:Adult patients with a hypertension diagnosis between November 2006 and September 2008. MAIN OUTCOME MEASURES:Blood ...
journal_title:Ethnicity & disease
pub_type: 杂志文章,多中心研究
doi:
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The objective was to investigate how data on race and ethnicity are collected by hospitals reporting to the New Hampshire State Cancer Registry (NHSCR). METHOD:NHSCR surveyed hospitals asking how information on race and ethnicity were collected. A review of relevant legal mandates and national guidelines wa...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2005-04-01 00:00:00
abstract::Fluctuations in ovarian hormones throughout the estrous cycle may underlie sex differences in behavior. In this study, estrogen plus progesterone were coadministered at different ratios to determine whether the interaction of those hormones during the estrous cycle contributes to cocaine-induced alterations in behavio...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2008-04-01 00:00:00
abstract:Introduction:Internet-based tobacco cessation programs have increased in use and popularity in recent years. To examine evidence for racial/ethnic digital inequality in web-only tobacco cessation services offered by US tobacco quitlines, we conducted an analysis of quitline enrollees in five states. We hypothesized tha...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:10.18865/ed.29.3.495
更新日期:2019-07-18 00:00:00
abstract::Facing the conclusion of the twentieth century, cardiovascular disease (CVD) remains a major cause of morbidity and a leading contributor to mortality worldwide. Developing countries, including those in South America and the Caribbean, contribute substantially to the global burden of CVD. Indeed, 8 to 9 million deaths...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To examine acculturation as a correlate of cardiovascular disease screening practices among Mexican Americans. METHODS:A modified Behavioral Risk Factor Surveillance System (BRFSS) survey was administered to adults age 18 and older in four Chicago neighborhoods during the winter of 2000 (N=435). RESULTS:Reg...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of a 10-week aerobic exercise training intervention on blood pressure, cardiorespiratory fitness, and workload in African American women with prehypertension. DESIGN:After we obtained informed consent and medical clearance, each participant underwent baseline measurements, an a...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:Introduction:Almost 40% of the 63 million Americans who speak a language other than English have limited English proficiency (LEP). This communication barrier can result in poor quality care and potentially adverse health outcomes. Of particular interest is that the greatest proportion of LEP adults are aged >65 years ...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:10.18865/ed.30.4.603
更新日期:2020-09-24 00:00:00
abstract:BACKGROUND:Although minority populations suffer a disproportionately higher burden of tobacco-attributable morbidity and mortality, the church appears to be a promising avenue through which to pursue tobacco-cessation interventions in these communities. This report describes church-related correlates of tobacco use amo...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:Objective:To build upon research that investigates the health significance of familial and former incarceration with special emphasis on obesity risk among native-born Black (ie, African American) men. Methods:We analyzed data from the 2001-2003 National Survey of American Life (NSAL), focusing on native-born Black me...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:10.18865/ed.28.2.69
更新日期:2018-04-26 00:00:00
abstract:Objective:The National Research Mentoring Network (NRMN) is a strategic partnership whose goals include remedying documented disparities by race and ethnicity in the awarding of National Institutes of Health research grants. Our objectives were to offer a profile of early-career investigators who applied to NRMN's Gran...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:10.18865/ed.29.S1.123
更新日期:2019-02-21 00:00:00
abstract:BACKGROUND:Obesity is becoming a worldwide public health problem and it is expected to worsen as its prevalence is increasing in children and adolescents. This report examined the distribution of major cardiovascular disease (CVD) risk factors and the effect of life-style changes on coronary heart disease (CHD) risk pr...
journal_title:Ethnicity & disease
pub_type: 杂志文章
doi:
更新日期:2015-04-01 00:00:00