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National Healthcare Disparities Report, 2003

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Racial and Ethnic Differences in Health Care Utilization

Measure Racial Difference[1] Ethnic Difference[2]
  Black Asian NHOPI AI/AN >1 Race NHB Hispanic
Overall Health Care Utilization[3]
People with office or outpatient visit Selected population receives less care than the comparison population Selected population receives less care than the comparison population[3] Selected population and comparison population receive about same amount of health care   Selected population receives less care than the comparison population Selected population receives less care than the comparison population
People with prescription medications Selected population receives less care than the comparison population Selected population receives less care than the comparison population[3] Selected population receives less care than the comparison population   Selected population receives less care than the comparison population Selected population receives less care than the comparison population
People with dental visit Selected population receives less care than the comparison population Selected population receives less care than the comparison population[3] Selected population receives less care than the comparison population   Selected population receives less care than the comparison population Selected population receives less care than the comparison population
People with emergency room visit Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population[3] Selected population and comparison population receive about same amount of health care   Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population
People with inpatient discharge Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care[3] Selected population and comparison population receive about same amount of health care   Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care
People with home health visit Selected population and comparison population receive about same amount of health care Data are collected but do not meet criteria for statistical reliability[3] Data are collected but do not meet criteria for statistical reliability   Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population
Care in Doctor's Offices and Hospital Outpatient Departments[4]
Outpatient visits per 100 population Selected population receives less care than the comparison population Selected population and comparison population receive about same amount of health care[4] Selected population receives less care than the comparison population      
Outpatient visits where patient was seen before in clinic or practice Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care[4] Selected population receives less care than the comparison population      
Outpatient visits where patient was seen by patient's primary care provider Selected population receives more care than the comparison population Selected population receives more care than the comparison population[4] Selected population receives less care than the comparison population      
Outpatient visits where patient was seen for non-illness care Selected population and comparison population receive about same amount of health care Selected population receives more care than the comparison population[4] Selected population receives less care than the comparison population      
Outpatient visits with counseling or education about diet and nutrition Selected population receives more care than the comparison population Selected population receives more care than the comparison population[4] Data are collected but do not meet criteria for statistical reliability      
Outpatient visits with counseling or education about exercise Selected population and comparison population receive about same amount of health care Selected population receives more care than the comparison population[4] Data are collected but do not meet criteria for statistical reliability      
Outpatient visits with counseling or education about tobacco use and exposure Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care[4] Data are collected but do not meet criteria for statistical reliability      
Outpatient visits where physician spent more than 30 minutes with patient Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care[4] Selected population and comparison population receive about same amount of health care      
Referred Care[4]
Outpatient visits where patient was referred by another physician or health plan Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care[4] Selected population and comparison population receive about same amount of health care      
Outpatient visits where patient was referred to another physician Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care[4] Data are collected but do not meet criteria for statistical reliability      
Emergency Care[4]
Emergency department visits per 100 population Selected population receives more care than the comparison population Selected population receives less care than the comparison population[4] Selected population and comparison population receive about same amount of health care      
Emergency department visits related to injuries per 10,000 population Selected population receives more care than the comparison population Selected population receives less care than the comparison population[4] Data are collected but do not meet criteria for statistical reliability      
Emergency department visits for asthma per 10,000 population Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability[4] Data are collected but do not meet criteria for statistical reliability      
Emergency department visits where patient was seen by intern/resident only Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability[4] Data are collected but do not meet criteria for statistical reliability      
Measure Racial Difference[5] Ethnic Difference[6]
  Black Asian NHOPI AI/AN >1 Race NHB Hispanic
Mental Health Care and Substance Abuse Treatment
Adults who received mental health treatment or counseling in the past year[7] Selected population receives less care than the comparison population Selected population receives less care than the comparison population Data are collected but do not meet criteria for statistical reliability Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population Selected population receives less care than the comparison population
Adults who received outpatient mental health treatment or counseling[3] Selected population receives less care than the comparison population Selected population receives less care than the comparison population Data are collected but do not meet criteria for statistical reliability Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population Selected population receives less care than the comparison population
Adults who received prescription medications for mental health treatment[3] Selected population receives less care than the comparison population Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population Selected population receives less care than the comparison population
Adults who received inpatient mental health treatment or counseling[3] Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
Adults with serious mental illness who received mental health treatment or counseling[3] Selected population receives less care than the comparison population Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Selected population receives less care than the comparison population Selected population receives less care than the comparison population
People 12 and older who received illicit drug or alcohol abuse treatment in the past year[3] Selected population and comparison population receive about same amount of health care Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
People 12 and older who needed treatment at a specialty facility for illicit drug use and who received such treatment in the past year[3] Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
Inpatient admissions to specialty mental health organizations per 100,000 population[8] Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability[4] Data are collected but do not meet criteria for statistical reliability   Selected population receives more care than the comparison population Selected population receives less care than the comparison population
Residential care admissions to specialty mental health organizations per 100,000 population[4] Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability[4] Data are collected but do not meet criteria for statistical reliability   Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
<24 hour care admissions to specialty mental health organizations per 100,000 population[4] Selected population receives more care than the comparison population Selected population receives less care than the comparison population[4] Selected population receives more care than the comparison population   Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
HIV Care
Hospitalizations for HIV per 10,000 population[9] Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability      
HIV patients with 4+ ambulatory visits in the past year[10] *[6] Selected population and comparison population receive about same amount of health care[6] Selected population and comparison population receive about same amount of health care   Selected population receives less care than the comparison population Selected population and comparison population receive about same amount of health care
HIV patients with CD4 <50 with 4+ ambulatory visits in the past year[6] *[6] Data are collected but do not meet criteria for statistical reliability[6] Data are collected but do not meet criteria for statistical reliability   Selected population receives less care than the comparison population Selected population and comparison population receive about same amount of health care
HIV patients with inpatient hospitalization in the past year[6] *[6] Selected population and comparison population receive about same amount of health care[6] Selected population and comparison population receive about same amount of health care   Selected population receives more care than the comparison population Selected population receives more care than the comparison population
HIV patients with CD4 <50 with inpatient hospitalization in the past year[6] *[6] Data are collected but do not meet criteria for statistical reliability[6] Data are collected but do not meet criteria for statistical reliability   Selected population receives more care than the comparison population Selected population receives more care than the comparison population
Measure Racial Difference[11] Ethnic Difference[12]
  Black Asian NHOPI AI/AN >1 Race NHB Hispanic
Inpatient Care
Total hospitalizations per 100 population[13] Selected population receives more care than the comparison population Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability Data are collected but do not meet criteria for statistical reliability      
Avoidable admissions for hypertension per 100,000 population 18 and older[14] *[4] Selected population receives less care than the comparison population[4]     Selected population receives more care than the comparison population Selected population receives more care than the comparison population
Avoidable admissions for angina per 100,000 population 18 and older[4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
Avoidable admissions for chronic obstructive pulmonary disease per 100,000 population 18 and older[4] *[4] Selected population receives less care than the comparison population[4]     Selected population and comparison population receive about same amount of health care Selected population receives less care than the comparison population
Avoidable admissions for bacterial pneumonia per 100,000 population[4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
Perforated appendices per 1,000 admissions for appendicitis [4] *[4] Selected population and comparison population receive about same amount of health care[4]     Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
Admissions for PTCA per 100,000 population 40 and older[4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives less care than the comparison population Selected population receives less care than the comparison population
Admissions for coronary artery bypass graft surgery per 100,000 population 40+[4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives less care than the comparison population Selected population receives less care than the comparison population
Admissions for hysterectomy per 100,000 female population 18 and older[4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives more care than the comparison population Selected population receives less care than the comparison population
Admissions for laminectomy or spinal fusion per 100,000 population 18 and older[4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives less care than the comparison population Selected population receives less care than the comparison population
Cesarean deliveries per 1,000 deliveries [4] *[4] Selected population receives less care than the comparison population[4]     Selected population receives more care than the comparison population Selected population and comparison population receive about same amount of health care
Vaginal births per 1,000 women with previous Cesarean deliveries[4] *[4] Selected population receives more care than the comparison population[4]     Selected population and comparison population receive about same amount of health care Selected population and comparison population receive about same amount of health care
Chronic Care
Home Health Care Discharges per 10,000 Population 18-64[15] Selected population and comparison population receive about same amount of health care[5]            
Home Health Care Discharges per 10,000 Population 65 and older[5] Selected population and comparison population receive about same amount of health care[5]            
Nursing Home Discharges per 10,000 Population 18-64[16] Selected population receives more care than the comparison population[6]            
Nursing Home Discharges per 10,000 Population 65 and older[6] Selected population and comparison population receive about same amount of health care[6]            
Nursing Home Discharges Who Received Rehabilitative Services[6] Selected population and comparison population receive about same amount of health care[6]            
Nursing Home Discharges Who Received Mental Health Services[6] Selected population and comparison population receive about same amount of health care[6]            
Nursing Home Discharges Who Were Either Recovered or Stabilized[6] Selected population receives less care than the comparison population[6]            
Hospice Discharges per 100,000 Population 18-64[5] Selected population and comparison population receive about same amount of health care[5]            
Hospice Discharges per 100,000 Population 65+[5] Selected population receives less care than the comparison population[5]            
Key to Quality of Health Care Tables
Selected population and comparison population receive about same amount of health care: Selected population and comparison population receive about same amount of health care
Selected population receives more care than the comparison population: Selected population receives more care than the comparison population
Selected population receives less care than the comparison population: Selected population receives less care than the comparison population
Data are collected but do not meet criteria for statistical reliability: Data are collected but do not meet criteria for statistical reliability

[1] Compared with whites.

[2] Compared with non-Hispanic whites.

[3] Source: MEPS, 1999. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian or Pacific Islander. This source did not collect information for >1 race.

[4] Source: NAMCS/NHAMCS, 1999-2000. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian or Pacific Islander. This source did not collect information for >1 race. Missing rates preclude analysis by ethnicity.

[5] Compared with whites.

[6] Compared with non-Hispanic whites.

[7] Source: NHSDA, 2001.

[8] Source: SAMHSA's Client/Patient Survey Sample, 1997. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian or Pacific Islander. This source did not collect information for >1 race.

[9] Source: NHDS, 2000. This source did not collect information for >1 race separately. Missing rates preclude analysis by ethnicity.

[10] Source: HIV Research Network, 2000. This source categorizes race/ethnicity very differently from other sources. Race/ethnicity information is categorized as a single item: Non-Hispanic white, Non-Hispanic black, Hispanic, Asian or Pacific Islander American Indian or Alaska Native. These contrasts compare each group with non-Hispanic whites. An * is inserted in the Black column to indicate that estimates for this group could not be produced.

[11] Compared with whites.

[12] Compared with non-Hispanic whites.

[13] Source: NHDS, 2000. This source did not collect information for >1 race separately. Missing rates preclude analysis by ethnicity.

[14] Source: HCUP SID 16 state database, 2000. This source categorizes race/ethnicity very differently from other sources. Race/ethnicity information is categorized as a single item: Non-Hispanic white, Non-Hispanic black, Hispanic, Asian or Pacific Islander. These contrasts compare each group with non-Hispanic whites. An * is inserted in the Black column to indicate that estimates for this group could not be produced.

[15] Source: NHHCS, 2000. Sample size constraints permit black-white comparisons only.

[16] Source: NNHS, 1999. Sample size constraints permit black-white comparisons only.

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