A comparison of direct medical costs across racial and ethnic groups among children with cancer

Wang, Junling; Dong, Zhiyong; Hong, Song Hee; Suda, Katie J.

doi:10.1185/030079908x273390

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…12 Nonetheless, because of the repeated documentation of racial and ethnic disparities in the use and costs of prescription medications, it is hard to imagine that a more detailed analysis would produce differential disparity patterns. 6,7,20,21,32, 33 Additionally, because minorities may be equally or less likely to enroll in Medicare Part D compared to Whites, 34,35 as far as selection bias is concerned, this study may have underestimated the disparity issues among the minority population than Whites. However, because this study found evidence of disparities, the selection bias issue should not be a major concern.…”

Section: Discussionmentioning

confidence: 97%

Historical trend of disparity implications of Medicare MTM eligibility criteria

Wang¹,

Qiao²

2013

Research in Social and Administrative Pharmacy

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Background Non-Hispanic Blacks (Blacks) and Hispanics have a lower likelihood of being eligible for medication therapy management (MTM) services than do non-Hispanic Whites (Whites) based on Medicare MTM eligibility criteria. Objective To determine whether MTM eligibility criteria would perform differently over time, this study examined the trend of MTM disparities from 1996–1997 to 2007–2008. Methods The study populations were Medicare beneficiaries from the Medical Expenditure Panel Survey. Proportions and the odds of MTM eligibility were compared between Whites and ethnic minorities. The trend of disparities was examined by including in logistic regression models interaction terms between dummy variables for the minority groups and 2007–2008. MTM eligibility thresholds for 2008 and 2010–2011 were analyzed. Main and sensitivity analyses were conducted to represent the entire range of the eligibility criteria. Results This study found no statistical significant racial or ethnic disparities associated with the MTM eligibility criteria for 2008 among the Medicare population during 1996–1997. However, racial disparities associated with 2010–2011 MTM eligibility criteria were significant according to multivariate analyses among the Medicare population during 1996–1997. During 2007–2008, both racial and ethnic disparities associated with both 2008 MTM eligibility criteria and 2010–2011 eligibility criteria were generally significant. Disparity patterns did not exhibit a statistically significant change from 1996–1997 to 2007–2008. Conclusion Racial and ethnic disparities in meeting MTM eligibility criteria may not decrease over time unless MTM eligibility criteria are changed.

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Section: Discussionmentioning

confidence: 97%

Historical trend of disparity implications of Medicare MTM eligibility criteria

Wang¹,

Qiao²

2013

Research in Social and Administrative Pharmacy

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“…Although MTM eligibility thresholds have been lowered by CMS, MTM enrolment rates have continued to hover below CMS expectations, which suggests that not all eligible individuals enrolled in MTM services. Moreover, it is possible that racial and ethnic minorities may enrol at a lower rate than their white counterparts given that minorities tend to have worse access to health services . If this has been the case, this pattern may further complicate the disparity issues associated with MTM services.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is possible that racial and ethnic minorities may enrol at a lower rate than their white counterparts given that minorities tend to have worse access to health services. [32] If this has been the case, this pattern may further complicate the disparity issues associated with MTM services.…”

Section: Minority Groupsmentioning

confidence: 99%

Disparity implications of proposed 2015 Medicare eligibility criteria for medication therapy management services

Wang

Qiao

Spivey

et al. 2016

J Pharm Health Serv Res

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Objectives Previous studies found that racial and ethnic minorities may be less likely than non-Hispanic Whites (Whites) to meet existing Medicare medication therapy management (MTM) eligibility criteria. To address these issues, the Centers for Medicare & Medicaid Services (CMS) proposed alternative Medicare MTM eligibility criteria for 2015. Due to opposition to other Part D reforms proposed simultaneously by various stakeholders, CMS rescinded all proposed reforms. This study was conducted to determine whether non-Hispanic Blacks (Blacks) and Hispanics have lower likelihood of meeting the proposed 2015 Medicare MTM eligibility criteria. Methods This retrospective observational analysis used Medical Expenditure Panel Survey data (2010-2011). The final study sample was comprised of 2,721 Whites (weighted to 37,185,896), 917 Blacks (weighted to 4,665,644), and 538 Hispanics (weighted to 3,532,882). Chi-square tests were used to examine racial and ethnic disparities in meeting proposed 2015 MTM eligibility criteria and each component of proposed 2015 MTM eligibility criteria. In multivariate analysis, a logistic regression model was used to control for population socio-demographic and health-related characteristics. Key Findings Compared to Whites with a proportion of MTM eligibility of 58.82%, the eligible proportion was 57.09% (P=0.20) for Blacks, and 48.97% (P<0.0001) for Hispanics, respectively. According to multivariate logistic regression, odds ratios of meeting MTM eligibility for Blacks and Hispanics compared to Whites were 0.74 (95% Confidence Internal [CI] = 0.62-0.88) and 0.53 (95% CI=0.43-0.67), respectively. Conclusions The proposed 2015 MTM eligibility criteria would not eliminate racial and ethnic disparities in MTM eligibility. Alternative MTM eligibility criteria should be devised.

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“…Previous literature has reported various causes for the lower utilization of health services and pharmaceutical products among minorities than among whites. These causes can again be summarized as predisposing, enabling, and need factors (e.g., Briesacher, Limcangco, and Gaskin 2003; Wang et al 2006, 2007b, 2008). Regardless of the causes for the lower utilization among racial and ethnic minorities, because MTM eligibility criteria are predominantly based on utilizations, our study found that there would be a lower likelihood of meeting MTM eligibility criteria among racial and ethnic minorities than among whites.…”

Section: Discussionmentioning

confidence: 99%

Disparity Implications of Medicare Eligibility Criteria for Medication Therapy Management Services

Wang

Mullins

Brown

et al. 2010

Health Services Research

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Objective. To determine whether there would be racial and ethnic disparities in meeting eligibility criteria for medication therapy management (MTM) services implemented in 2006 for Medicare beneficiaries. Data Sources/Study Setting. Secondary data analyses of the Medical Expenditure Panel Survey (2004)(2005). Study Design. Logistic regression and recycled predictions were used to test the disparities in meeting eligibility criteria across racial and ethnic groups. The eligibility thresholds used by health plans in 2006 and new thresholds recommended for 2010 were examined. Racial and ethnic disparities were examined by comparing non-Hispanic blacks (blacks) with non-Hispanic whites (whites) and comparing Hispanics with whites, respectively. Disparities were also examined among individuals with severe health problems. Principal Findings. According to 2006 thresholds, the adjusted odds ratios for meeting eligibility criteria for blacks and Hispanics to whites were 0.36-0.60 (po.05) and 0.13-0.46 (po.05), respectively. Blacks and Hispanics would be 21-34 and 32-38 percent, respectively, less likely to be eligible than whites according to recycled predictions. Similar patterns were found using the 2010 eligibility thresholds and among individuals with severe health problems. Conclusions. There would be racial and ethnic disparities in meeting MTM eligibility criteria. Future research is warranted to confirm the findings using data after MTM implementation.

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A comparison of direct medical costs across racial and ethnic groups among children with cancer

Abstract: This study did not identify significant racial and ethnic disparities in health care costs. However, one important study limitation is the small sample size of the minority populations in the study sample.

Cited by 8 publications

References 19 publications

Historical trend of disparity implications of Medicare MTM eligibility criteria

Historical trend of disparity implications of Medicare MTM eligibility criteria

Disparity implications of proposed 2015 Medicare eligibility criteria for medication therapy management services

Disparity Implications of Medicare Eligibility Criteria for Medication Therapy Management Services

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