Yue Li (
Xi Cen is a PhD candidate in the Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry.
Health Aff (Millwood). 2017 Jul 1;36(7):1328-1335. doi: 10.1377/hlthaff.2016.1344. Epub 2017 Jun 21.
We compared racial disparities in thirty-day readmissions between traditional Medicare and Medicare Advantage beneficiaries who underwent one of six major surgeries in New York State in 2013. We found that Medicare Advantage was associated with greater racial disparity, compared to traditional Medicare. After controlling for patient, hospital, and geographic characteristics in a propensity score based approach, we found that in traditional Medicare, black patients were 33 percent more likely than white patients to be readmitted, whereas in Medicare Advantage, black patients were 64 percent more likely than white patients to be readmitted. Our findings suggest that the risk-reduction strategies adopted by Medicare Advantage plans have not been successful in lowering the markedly higher rate of readmission among black patients, compared to white patients.
我们比较了 2013 年在纽约州进行六种主要手术的传统医疗保险和医疗保险优势受益人的 30 天再入院率的种族差异。我们发现,与传统医疗保险相比,医疗保险优势与更大的种族差异相关。在倾向评分匹配方法中控制患者、医院和地理特征后,我们发现,在传统医疗保险中,黑人患者的再入院率比白人患者高 33%,而在医疗保险优势中,黑人患者的再入院率比白人患者高 64%。我们的研究结果表明,与白人患者相比,医疗保险优势计划所采用的风险降低策略并未成功降低黑人患者明显更高的再入院率。