阿尔茨海默病患者医疗费用的健康差异：对 4 个州医疗补助人群的分析。
Health disparities in cost of care in patients with Alzheimer's disease: an analysis across 4 state Medicaid populations.
机构信息
College of Pharmacy-Pulido Center, Tucson AZ 85721, USA.
出版信息
Am J Alzheimers Dis Other Demen. 2013 Feb;28(1):84-92. doi: 10.1177/1533317512467679. Epub 2012 Nov 29.
OBJECTIVES
To investigate health disparities with respect to cost of care across 4 state Medicaid populations.
METHODS
Data were obtained from Centers for Medicare and Medicaid Services (CMS) for this retrospective study. Patients were enrolled in a California, Florida, New Jersey, or New York Medicaid programs during 2004, with a diagnosis of Alzheimer's disease (International Classification of Diseases, Ninth Revision 331.0). Outcome of interest was cost of care. Decomposition of cost to calculate disparities was estimated using the Oaxaca-Blinder model. An a priori α level of .01 was used.
RESULTS
Approximately 158 974 individuals qualified for this study. Disparities were found to exist between blacks and whites (with blacks having higher costs; P < .0001), whites and others (with whites having higher costs; P < .0001), blacks and Hispanics (with blacks having higher costs; P < .0001), blacks and others (with blacks having higher costs; P < .0001), and Hispanics and others (with Hispanics having higher costs; P < .0001).
CONCLUSIONS
Disparities in cost among minority-to-minority populations were just as prevalent, if not higher, than minority-white disparities.
目的
调查 4 个州的医疗补助计划人群中医疗费用方面的健康差异。
方法
本回顾性研究的数据来自医疗保险和医疗补助服务中心（CMS）。2004 年期间，患者在加利福尼亚州、佛罗里达州、新泽西州或纽约州的医疗补助计划中登记，患有阿尔茨海默病（国际疾病分类，第九版 331.0）。关注的结果是医疗费用。使用 Oaxaca-Blinder 模型对成本分解进行差异估计。使用预先设定的 α 水平为.01。
结果
大约有 158974 人符合这项研究的条件。发现黑人和白人之间存在差异（黑人的费用更高；P<.0001），白人和其他人之间存在差异（白人的费用更高；P<.0001），黑人和西班牙裔之间存在差异（黑人的费用更高；P<.0001），黑人和其他人之间存在差异（黑人的费用更高；P<.0001），西班牙裔和其他人之间存在差异（西班牙裔的费用更高；P<.0001）。
结论
少数群体内部之间的成本差异，如果不比少数群体与白人之间的差异更普遍的话，也同样普遍。
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