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ER Use among Older Adult RHC Medicare Beneficiaries in the Southeastern United States

Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities

ISBN: 978-1-83982-799-0, eISBN: 978-1-83982-798-3

ISSN: 0275-4959

Publication date: 28 September 2020

Abstract

Purpose – This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4.

Methodology/approach – A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression.

Findings – This study found that dual eligible RHC patients utilized ER services at higher rates than nondual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively.

Research limitations/implications – Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socioeconomic status, and race continue to influence higher rates of ER utilization in CMS Region 4.

Originality/value – In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 years and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.

Keywords

Acknowledgements

Other disclaimers:

This research was supported, in part, by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under federal grant award number U24MD006954. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

UCF IRB approval was obtained for this research.

Citation

Bagwell, M.T. and Wan, T.T.H. (2020), "ER Use among Older Adult RHC Medicare Beneficiaries in the Southeastern United States", Kronenfeld, J.J. (Ed.) Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities (Research in the Sociology of Health Care, Vol. 38), Emerald Publishing Limited, Bingley, pp. 49-72. https://doi.org/10.1108/S0275-495920200000038008

Publisher

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Emerald Publishing Limited

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