ArticleJournal of general internal medicine2022
Provider Network Structure and Black-to-White Disparity Gaps for Medicare Patients with Diabetes: County-Level Analysis of Cost, Utilization, and Clinical Care.
Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- A Scoping Review of Multilevel Patient-Sharing Network Measures in Health Services Research.Medical care research and review : MCRR · 2025Article
- Rural-Urban Differences in Patient-Sharing by Clinicians Caring for Children with Medical Complexity: Network Analysis of the Pediatric Workforce in Three States.The Journal of pediatrics · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundPrior work has shown that provider network structures correlate with outcomes such as patient costs, utilization, and care. However, it remains unknown whether certain provider networks are associated with reduced disparity gaps.
methodsWe study the population of Medicare beneficiaries with diabetes who were continuously enrolled in Medicare FFS in 2016. Using multivariable regression analysis of county-level risk adjusted cost, hospitalization, emergency department visits, A1c testing, and preventable diabetes-related hospitalizations, we measure the effect that the relative network connectivity of primary care providers (PCPs) in relation to medical and surgical specialists (PCP/Specialist degree centrality ratio), derived from Medicare patient sharing data, has on non-Hispanic black-to-white disparity gaps controlling for county-level socioeconomic and demographic variables and state fixed effects.
resultsRelative to non-Hispanic white, our adjusted results show that non-Hispanic black beneficiaries have $1673 (p<0.001) higher risk adjusted total costs, 2.6 (p<0.001) more hospitalizations (per 1000 beneficiaries), 11.6 (p<0.001) more ED visits (per 1000 beneficiaries), receive 2.2% (p<0.001) less A1c testing, and have 69.4 (p<0.01) more (per 100,000) avoidable diabetes-related hospital admissions. Our main results show that increasing the PCP/Specialist degree centrality ratio by one standard deviation is associated with a disparity gap decrease of 25.3% (p<0.01) in hospitalizations, 8.3% (p<0.05) in ED visits, 2.8% (p<0.01) in A1c testing, and 26.9% (p<0.1) in the volume of preventable diabetes-related hospital admissions.
conclusionsNetwork structures where PCPs are more central relative to medical and surgical specialists are associated with reduced non-Hispanic black-to-white disparity gaps, suggesting that how we organize and structure our health systems has implications for disparity gaps between non-Hispanic black and white Medicare beneficiaries with diabetes.
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