Racial Disparities in Diabetes Hospitalization of Rural Medicare Beneficiaries in 8 Southeastern States:

Health Services Research & Managerial Epidemiology

Thomas T. H.Wan¹ 

关键词: community health;    managerial epidemiology;    rural health;    disease management;    impact evaluation;   

DOI  :  10.1177/2333392816671638

学科分类：医学（综合）

来源: Sage Journals

【 摘 要 】

This study examined racial variability in diabetes hospitalizations attributable to contextual, organizational, and ecological factors controlling for patient variabilities treated at rural health clinics (RHCs). The pooled cross-sectional data for 2007 through 2013 for RHCs were aggregated from Medicare claim files of patients served by RHCs. Descriptive statistics were presented to illustrate the general characteristics of the RHCs in 8 southeastern states. Regression of the dependent variable on selected predictors was conducted using a generalized estimating equation method. The risk-adjusted diabetes mellitus (DM) hospitalization rates slightly declined in 7 years from 3.55% to 2.40%. The gap between the crude and adjusted rates became wider in the African American patient group but not in the non-Hispanic white patient group. The average DM disparity ratio increased 17.7% from the pre-Affordable Care Act (ACA; 1.47) to the post-ACA period (1.73) for the African American patient group. The results sh...

【 授权许可】

CC BY