Jeah Jung (
Hansoo Ko, George Mason University.
Health Aff (Millwood). 2024 Mar;43(3):381-390. doi: 10.1377/hlthaff.2023.00428.
The quality of care experienced by members of racial and ethnic minority groups in Medicare Advantage, which is an increasingly important source of Medicare coverage for these groups, has critical implications for health equity. Comparing gaps in Medicare Advantage and traditional Medicare for three quality-of-care outcomes, measured by adverse health events, between minority and non-Hispanic White populations, we found that the relative magnitude of the gaps varied both by racial and ethnic minority group and by quality measure. Hispanic versus non-Hispanic White gaps were smaller in Medicare Advantage than in traditional Medicare for all outcomes: avoidable emergency department use, preventable hospitalizations, and thirty-day hospital readmissions. The gap between non-Hispanic Black and non-Hispanic White populations was larger in Medicare Advantage than in traditional Medicare for avoidable emergency department use but was no different for hospital readmissions and was smaller for preventable hospitalizations. The Asian versus non-Hispanic White gap was similar in Medicare Advantage and traditional Medicare for avoidable emergency department use and preventable hospitalizations but was larger in Medicare Advantage for hospital readmissions. As Medicare Advantage enrollment expands, monitoring the quality of care for enrollees who are members of racial and ethnic minority groups will remain important.
医疗保险优势计划中,少数族裔和种族群体所经历的医疗保健质量对健康公平具有重要影响,因为该计划是这些群体获得医疗保险的一个越来越重要的来源。通过比较少数民族和非西班牙裔白人在三种医疗保健质量结果方面的医疗保险优势计划和传统医疗保险之间的差距,这些结果通过不良健康事件来衡量,我们发现,差距的相对大小因种族和少数民族群体以及质量衡量标准而异。在医疗保险优势计划中,西班牙裔与非西班牙裔白人之间的差距在所有结果上均小于传统医疗保险:可避免的急诊使用、可预防的住院治疗和 30 天内的再次住院。在医疗保险优势计划中,非西班牙裔黑人与非西班牙裔白人之间的差距在可避免的急诊使用方面大于传统医疗保险,但在住院再入院方面没有差异,而在可预防的住院治疗方面则较小。在医疗保险优势计划和传统医疗保险中,亚洲人与非西班牙裔白人之间的差距在可避免的急诊使用和可预防的住院治疗方面相似,但在住院再入院方面,医疗保险优势计划中的差距较大。随着医疗保险优势计划的 enrollee 不断扩大,监测该计划中属于少数族裔和种族群体的参保人的医疗保健质量仍然很重要。