Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC.
Ann Fam Med. 2024 Sep-Oct;22(5):383-391. doi: 10.1370/afm.3140.
Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.
This descriptive cross-sectional study used 2016 Medicaid claims data from the Transformed Medicaid Statistical Information System and from 2016-2017 American Board of Family Medicine certification questionnaire responses to examine the diversity and Medicaid participation of FPs. We explored the diversity of FP Medicaid patient panels and whether they saw ≥150 beneficiaries in 2016. Using logistic regression models, we controlled for FP demographics, practice characteristics, and characteristics of the communities in which they practiced.
Of 13,096 FPs, Latine, Hispanic, or of Spanish Origin (LHS) FPs and non-LHS Black FPs saw more Medicaid beneficiaries compared with non-LHS White and non-LHS Asian FPs. The patient panels of URiM FPs had a much greater proportion of Medicaid beneficiaries from racial and ethnic minority groups. Overall, non-LHS Black and LHS FPs had greater odds of seeing ≥150 Medicaid beneficiaries in 2016.
These findings clearly show the critical role URiM FPs play in caring for Medicaid beneficiaries, suggesting physician race and ethnicity are correlated with Medicaid participation. Diversity in the health care workforce is essential for addressing racial health inequities. Policies need to address problems in pathways to medical education, including failures to recruit, nurture, and retain URiM students.
尽管代表少数族裔和族裔群体的患者获得更好的健康结果至关重要，但在美国医疗保健系统中，代表性不足的医学专业人员（URiM）医生的比例仍然很低。本研究将全国代表性的家庭医生（FP）样本与医疗补助计划（Medicaid）索赔数据联系起来，以探讨 FP 种族和族裔对 Medicaid 人群护理的相对贡献。
本描述性横断面研究使用了 2016 年来自 Transformed Medicaid Statistical Information System 的 Medicaid 索赔数据和 2016-2017 年美国家庭医学委员会认证问卷的回复，以检查 FP 的多样性和 Medicaid 参与情况。我们探讨了 FP Medicaid 患者群体的多样性，以及他们是否在 2016 年看到了≥150 名受益人。使用逻辑回归模型，我们控制了 FP 的人口统计学特征、实践特征以及他们所在社区的特征。
在 13096 名 FP 中，Latine、Hispanic 或西班牙裔（LHS）FP 和非 LHS 黑 FP 与非 LHS 白人和非 LHS 亚洲 FP 相比，看到了更多的 Medicaid 受益人。URiM FP 的患者群体中，来自少数族裔和族裔群体的 Medicaid 受益人的比例要大得多。总体而言，非 LHS 黑人和 LHS FP 在 2016 年看到≥150 名 Medicaid 受益人的可能性更大。
这些发现清楚地表明，URiM FP 在照顾 Medicaid 受益人的过程中发挥了至关重要的作用，这表明医生的种族和族裔与 Medicaid 的参与有关。医疗保健劳动力的多样性对于解决种族健康不平等问题至关重要。政策需要解决医学教育途径中的问题，包括未能招募、培养和留住 URiM 学生。
