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Minority Health Disparities Impacting Care Access, Management

Minority health disparities affect care access, coordination, chronic disease management, and mental health treatment in Medicare, according to CMS.

Minority health disparities impact care access and management

Source: Thinkstock

By Jessica Kent

- Minority health disparities continue to impact several quality metrics, including care access, provider communication, chronic disease management, and mental health treatment, according to a new CMS report.

CMS stated that in order to address care disparities, it is necessary to understand where these gaps exist.

“Assessing equitability in the delivery of care requires making comparisons of quality by personal characteristics of patients such as gender, race, and ethnicity,” the organization said.

For the report, CMS examined data on the quality of healthcare received by Medicare beneficiaries across the country in 2016.

The report evaluated measures clinical outcomes as well as patient experience metrics, which include timely access to care and care coordination.

Disparities in these metrics ran along racial and ethnic lines, the data revealed.  For example, Asian and Pacific Islander (API) men and women were 10 percent less likely than white patients to report timely access to appointments with a provider.

Black men were also less likely to receive timely care than their white counterparts. Sixty-six percent of black males reported getting appointments quickly, compared to nearly 73 percent of white men who reported the same.

The survey found considerable disparities in care coordination, particularly among API beneficiaries. API patients were between four and five percent less likely to report good experiences with care coordination than white patients. Hispanic men also showed significantly lower satisfaction in this measure than white men.

Clinical outcomes varied among racial and ethnic groups, with some minority groups reporting better experiences in clinical outcomes than white patients. However, the report revealed several disparities in this area, including differences in chronic disease management and mental health treatment.

Only 57 percent of black women and 64 percent of Hispanic women with hypertension reported that their blood pressure was adequately controlled, compared to 70 percent of white women.

Black and Hispanic men with hypertension also reported significantly lower rates of blood pressure control, at 57 percent and 63 percent, respectively.  In contrast, 70 percent of white men said the same.

Black patients with diabetes showed lower rates of blood sugar control than other racial and ethnic groups, with just over 70 percent of black men and women meeting this quality metric.

In comparison, nearly 90 percent of API patients and 80 percent of white patients with diabetes reported having controlled blood sugar.

Black diabetic patients were also less likely than other racial and ethnic groups to have eye exams, controlled blood pressure, and blood sugar tests.

All minority groups reported significantly lower rates of antidepressant medication management than their white counterparts, both in the acute (84 days after diagnosis) and continuation (180 days after diagnosis) phases of treatment.

These findings are troubling, as depression is particularly prevalent in older populations and minority groups and the condition can be debilitating.

Black men and women reported the worst rates in these measures. Fifty-nine percent of black women and 56 percent of black men remained on antidepressants in the acute phase, and just 42 percent of black women and 40 percent of black men did so in the continuation phase.

Other notable findings from the report include:

  • API men and women were three percent less likely than their white counterparts to report good experiences with provider communication
  • White women were ten percent more likely to have received the flu vaccine than black and Hispanic women, while white men were about nine percent more likely to have received it than black and Hispanic men
  • Hispanic and black men and women with chronic renal failure were more likely to have received a prescription for potentially harmful medication than white patients
  • Hispanic men and women with dementia or a history of falls are the most likely among the included ethnic groups to have been prescribed potentially harmful medication
  • Black men and women had the lowest reported rates of follow-up visits after being in the hospital for mental illness, at just 23 and 28 percent respectively

CMS expects that healthcare stakeholders will utilize this report and accompanying resources to develop interventions, implement quality improvement efforts, and enhance outcomes for racially and ethnically diverse beneficiaries.

By highlighting where disparities exist, CMS can allow providers to close healthcare gaps and improve minority health.

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