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Receipt of preventive services among privately insured minorities in managed care versus fee-for-service insurance plans.

Abstract：

OBJECTIVE:We compare preventive services utilization among privately insured African Americans and Hispanics in managed care organizations (MCOs) versus fee-for-service (FFS) plans. We also examine racial/ethnic disparities in the receipt of preventive services among enrollees in FFS or MCO plans. DESIGN:Analysis of the nationally representative 1996 Medical Expenditure Panel Survey. PARTICIPANTS:Participants included 1,120 Hispanic, 929 African-American, and 6,383 non-Hispanic white (NHW) adults age 18 to 64 years with private health insurance. MEASUREMENTS AND MAIN RESULTS:We examined self-reported receipt of physical examination, blood pressure measurement, cholesterol assessment, Papanicolau testing, screening mammography, and breast and prostate examinations. Multivariate modeling was used to adjust for age, gender, education, household income, and health status. Hispanics in MCOs were more likely than their FFS counterparts to report having preventive services, with adjusted differences ranging from 5 to 19 percentage points (P <.05 for physical examination, blood pressure measurement, breast examination and Pap smear). Among African Americans, such patterns were of a smaller magnitude. In both MCOs and FFS plans the proportion of African Americans reporting preventive services was equal to or greater than NHWs. In contrast, among Hispanic women in FFS, a non-statistically significant trend of fewer cancer screening tests than NHW's was observed (Pap smears 75% vs 80%; mammograms 66% vs 74%, respectively). In both MCO and FFS plans, Hispanics were less likely than NHWs to report having blood pressure and cholesterol measurement (P <.05). CONCLUSIONS:With the demise of traditional MCOs, reform efforts should incorporate those aspects of MCOs that were associated with greater preventive service utilization, particularly among Hispanics. Existing ethnic disparities warrant further attention.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

DeLaet DE,Shea S,Carrasquillo O

doi

10.1046/j.1525-1497.2002.10512.x

subject

Has Abstract

pub_date

2002-06-01 00:00:00

pages

451-7

issue

eissn

0884-8734

issn

1525-1497

pii

jgi10512

journal_volume

pub_type

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Receipt of preventive services among privately insured minorities in managed care versus fee-for-service insurance plans.