Racial Disparities in Service Use among Medicaid Beneficiaries after Mandatory Enrollment in Managed Care: A Difference-in-Differences Approach

2001 ◽  
Vol 38 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Ming Tai-Seale ◽  
Deborah Freund ◽  
Anthony LoSasso
Keyword(s):  
Managed Care ◽  
Racial Disparities ◽  
Access To Health Care ◽  
Service Use ◽  
Underserved Populations ◽  
Count Data Models ◽  
Difference In Differences ◽  
Access To Health ◽  
Medicaid Eligibility ◽  
Medicaid Beneficiaries

Managed care may improve access to health care to previously underserved populations when providers need plan enrollees. However, capitation and utilization management often give providers the incentive to withhold care. Managed care organizations have yet to demonstrate that racial disparities in treatment are not exacerbated. Using Medicaid eligibility, claims, and managed care encounter data, we examine racial disparities in service use among Medicaid beneficiaries after mandatory enrollment in managed care. We use count data models adjusted for nonrandom selection within difference-in-differences econometric approaches. The results show that mandatory enrollment has disproportionately reduced the relative use of physician and inpatient services among African-American beneficiaries.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Quality of Life: Erosions and Opportunities Under Managed Care

2000 ◽  
Vol 28 (2) ◽  
pp. 144-158 ◽  
Author(s):  
E. Haavi Morreim
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Managed Care ◽  
Functional Status ◽  
General Public ◽  
Access To Health Care ◽  
New Technologies ◽  
Access To Health ◽  
Disease Specific

In recent years a number of commentators have discussed the importance of measuring quality of life (QL) in health care. We want to know whether an intervention will help people to live better, not just longer, and whether some treatments cause more trouble than they are worth. New technologies promise wondrous benefits. But when millions of people have no insured access to health care, and when many others face increasingly stringent limits on care, technologies’ high costs require us to choose what we should do from the broader universe of what we can do.The challenges to measuring QL are formidable. Researchers debate whether to measure general QL or disease-specific QL; whether to focus on functional status such as the patient's ability to walk and dress himself, or on the value people ascribe to that functional status; whether to seek the values of the general public, or to concentrate on people actually affected by a given disease or disability.

The intersection of developmental vulnerability and socioeconomic disadvantage on access to health care for preschool aged children: evidence for the inverse-care law

2019 ◽  
Author(s):  
Sue Woolfenden ◽  
Claire Galea ◽  
Hannah Badland ◽  
Hayley Smithers-Sheedy ◽  
Katrina Williams ◽  
...  
Keyword(s):  
Health Services ◽  
Access To Health Care ◽  
Parental Education ◽  
Service Use ◽  
Socioeconomic Disadvantage ◽  
Access To Health Services ◽  
Health Services Use ◽  
Cross Sectional ◽  
Inverse Care Law ◽  
Access To Health

Abstract Aim. Children who are developmentally vulnerable have greater health needs. Socioeconomic disadvantage not only increases this risk of developmental vulnerability but can be associated with less access to health services. Our aim was to compare health services use in children aged 4-5 years in Australia with and without developmentally vulnerability and consider the intersection of socioeconomic disadvantage on this relationship. Method. Cross sectional data were collected from Wave 3 of the Longitudinal Study of Australian Children birth cohort when the children were aged 4-5 years. A composite variable for developmental vulnerability was designed by combining those children who were in the lowest 15% in the physical, socioemotional and/or learning outcome indices. Children were then subgrouped according to developmental vulnerability and disadvantage based on socioeconomic position (SEP) quintile (derived from parental education, occupation, household income). We defined SEP 1 the lowest quintile as ‘disadvantaged’ and SEP quintiles 2-5 as ‘not disadvantaged’. Multivariate regression was used to examine the intersection between health service use and developmental vulnerability and disadvantage using these composite variables. Results The total number of children with information on developmental vulnerability in Wave 3 was 3967 (90% of the sample). A total of 1292 (32.6%) children were classified as developmentally vulnerable. 30.6% of children who were developmentally vulnerable came from families who were disadvantaged. Overall children who were developmentally vulnerable were reported to use more specialist/hospital health services than those who were not developmentally vulnerable (10-25 % vs 5-16%). Children who were developmentally vulnerable and not disadvantaged were 1.4-2.0 times more likely to have reported using a GP, paediatrician, other specialist, and Emergency Department compared with children who were developmentally vulnerable and disadvantaged. Conclusion Preschool children who are developmentally vulnerable have a higher reported use of specialist and hospital services compared with those who are not developmentally vulnerable. There is evidence of an inverse care law; those who were not disadvantaged with and without developmental vulnerability are more likely to use health services compared with their counterparts who were disadvantaged.

scholarly journals Equal access to health care reduces racial disparities in prostate cancer outcomes

Cancer ◽  
2020 ◽  
Vol 126 (18) ◽  
pp. 4256-4257
Author(s):  
Connor G. Hoge ◽  
Jonathan Sussman ◽  
Abhinav Sidana
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Racial Disparities ◽  
Access To Health Care ◽  
Equal Access ◽  
Cancer Outcomes ◽  
Access To Health

scholarly journals On the Demand for Telemedicine: Evidence from the Covid-19 Pandemic

2021 ◽  
Author(s):  
Matías Busso ◽  
María P. González ◽  
Carlos Scartascini
Keyword(s):  
Internal Medicine ◽  
Access To Health Care ◽  
Low Cost ◽  
Proof Of Concept ◽  
Older Individuals ◽  
Difference In Differences ◽  
Administrative Records ◽  
Access To Health ◽  
Percent Increase ◽  
Experience Good

Telemedicine can expand access to health care at relatively low cost. Historically, however, demand for telemedicine has remained low. Using administrative records and a difference-in-differences methodology, we estimate the change in demand for telemedicine experienced after the onset of the COVID-19 epidemic and the imposition of mobility restrictions. We find a 233 percent increase in the number of telemedicine calls and a 342 percent increase in calls resulting in a medication being prescribed. The effects were mostly driven by older individuals with pre-existing conditions who used the service for internal medicine consultations. The demand for telemedicine remains high even after mobility restrictions were relaxed, which is consistent with telemedicine being an experience good. These results are a proof of concept for policymakers willing to expand access to healthcare using advances in technology.

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