Evidence map›Paper›PMID 30628052›Full record

ArticleHealth services research2019

National racial/ethnic and geographic disparities in experiences with health care among adult Medicaid beneficiaries.

Steven C Martino, Megan Mathews, Denis Agniel, Nate Orr, Shondelle Wilson-Frederick, Judy H Ng, A Elizabeth Ormson, Marc N Elliott

Abstract read
In one paragraph

Article in Health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Steven C MartinoRAND Corporation, Pittsburgh, Pennsylvania.ORCID 0000-0002-1514-4133
Megan MathewsRAND Corporation, Santa Monica, California.
Denis AgnielRAND Corporation, Santa Monica, California.
Nate OrrRAND Corporation, Santa Monica, California.
Shondelle Wilson-FrederickOffice of Minority Health, Centers for Medicare & Medicaid Services, Baltimore, Maryland.
Judy H NgNational Committee for Quality Assurance, Washington, District of Columbia.
A Elizabeth OrmsonNORC, Atlanta, Georgia.
Marc N ElliottRAND Corporation, Santa Monica, California.ORCID 0000-0002-7147-5535

Funding

Centers for Medicare and Medicaid Services HHSM-500-2016-00097G
6 · The paper itself

Abstract

objectivesTo investigate whether health care experiences of adult Medicaid beneficiaries differ by race/ethnicity and rural/urban status. DATA SOURCES: A total of 270 243 respondents to the 2014-2015 Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems Survey. STUDY

designLinear regression was used to estimate case mix adjusted differences in patient experience between racial/ethnic minority and non-Hispanic white Medicaid beneficiaries, and between beneficiaries residing in small urban areas, small towns, and rural areas vs large urban areas. Dependent measures included getting needed care, getting care quickly, doctor communication, and customer service. PRINCIPAL

findingsCompared with white beneficiaries, American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (API) beneficiaries reported worse experiences, while black beneficiaries reported better experiences. Deficits for AIAN beneficiaries were 6-8 points on a 0-100 scale; deficits for API beneficiaries were 13-22 points (P's < 0.001); advantages for black beneficiaries were 3-5 points (P's < 0.001). Hispanic white differences were mixed. Beneficiaries in small urban areas, small towns, and isolated rural areas reported significantly better experiences (2-3 points) than beneficiaries in large urban areas (P's < 0.05), particularly regarding access to care. Racial/ethnic differences typically did not vary by geography.

conclusionsImproving experiences for racial/ethnic minorities and individuals living in large urban areas should be high priorities for policy makers exploring approaches to improve the value and delivery of care to Medicaid beneficiaries.

Indexed as

Consumer BehaviorEthnicityHealthcare DisparitiesHealth Services AccessibilityRural PopulationUrban PopulationAdultAgedAmerican Indian or Alaska NativeAsian American Native Hawaiian and Pacific IslanderBlack or African AmericanFemaleHumansMaleMedicaidMiddle AgedCAHPSdisparitiesMedicaidpatient experiencerace/ethnicityurbanicity/rurality

Identifiers

PMID30628052
PMCPMC6341217

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.