Is there a difference in hypertensive claim rates among Medicaid recipients?

The purpose of this study was to determine whether there are racial differences in the rates of prevalence and new claims to Medicaid for hypertension treatment in a population of uniformly low economic status--i.e., Georgia Medicaid recipients. Age-specific and age-adjusted prevalence rates of hypertension in 1991 and the first 1991 claim rates by race and gender were calculated. Gender-specific black-to-white risk ratios, using the Mantel-Haenszel pooled point estimate (RMH) and the corresponding test-based 95 percent confidence interval (CI) were also calculated. African-American females were more likely than African-American males, or whites of either sex to have hypertension diagnoses. For newly claimed cases, the gender-specific black-to-white risk ratios were significant in malignant hypertension for both females (RMH = 1.9, 95 percent CI 1.4-2.5) and males (RMH = 2.0, 95 percent CI 1.2-3.7) and in unspecified hypertension for females (RMH = 1.5, 95 percent CI 1.4-1.6), but were less significant in unspecified hypertension for males, and in benign hypertension for both sexes. Using Medicaid data may have caused underestimation of the prevalence and incidence of hypertension among Medicaid recipients; however, significant racial differences in the "occurrence" of hypertension still existed among them. Factors other than the household income status may be responsible for much of the excess risk of hypertension in the black Medicaid population.