Measuring Trends in Racial/Ethnic Health Care Disparities

Abstract:     
Objectives. To compare estimated trends in disparities by two definitions of racial/ethnic disparities. To provide guidance to national efforts tracking progress in disparities reduction.

Data Sources. Secondary, cross-sectional data from the 1996/7 and 2003/4 Medical Expenditure Panel Survey (MEPS).

Study Design. We estimate trends in having any outpatient or office-based visit and total medical expenditure in the last year. We compare disparities based on unadjusted means (AHRQ) to estimates adjusting for health status as proposed by the Institute of Medicine (IOM).

Principal Findings. Black-white disparities in having an office-based or outpatient visit and medical expenditure were roughly constant between 1996/7 and 2003/4, regardless of the measure and method used. By contrast, both methods find increasing Hispanic-white disparities for office-based or outpatient visits and for Hispanic-white disparities in medical expenditure.

Conclusions. Levels and change in disparities are similar with both methods, although the AHRQ definition tends to produce larger estimates. Model-based estimates of trends in disparities are readily accomplished with MEPS data. No progress against disparities for blacks is evident for the outcomes studied; for Hispanics, disparities are worse.

Keywords: Racial disparities, trends, statistical adjustment for health status

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