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Health Aff (Millwood). 2017 Jul 1;36(7):1328-1335. doi: 10.1377/hlthaff.2016.1344. Epub 2017 Jun 21.

Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions.

Author information

1
Yue Li (yue_li@urmc.rochester.edu) is an associate professor in the Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, in New York.
2
Xi Cen is a PhD candidate in the Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry.
3
Xueya Cai is a research associate professor in the Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry.
4
Caroline P. Thirukumaran is an assistant professor in the Department of Orthopaedics and Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry.
5
Jie Zhou is an assistant professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Harvard Medical School and Brigham and Women's Hospital, both in Boston, Massachusetts.
6
Laurent G. Glance is vice chair for research and a professor in the Department of Anesthesiology and Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry.

Abstract

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.

KEYWORDS:

30-day readmission; Medicare Advantage; racial/ethnic disparity; surgical outcome

PMID:
28637771
DOI:
10.1377/hlthaff.2016.1344
[Indexed for MEDLINE]

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