Dataset Information

The association between care experiences and parent ratings of care for different racial, ethnic, and language groups in a Medicaid population.

ABSTRACT:

Objective

To examine the association between care experiences and parent ratings of care within racial/ethnic/language subgroups.

Data source

National Consumer Assessment of Healthcare Providers and Systems Benchmarking Database 3.0 (2003-2006). Sample Characteristics. 111,139 parents of minor Medicaid managed care enrollees.

Study design

Cross-sectional observational study predicting "poor" (0-5 on 0-10 scale) parent ratings of personal doctor, specialist, health care, and health plan from care experiences for different parent race/ethnicity/language subgroups (Latino/Spanish, Latino/English, white, and black).

Principal findings

Care experiences had similar associations with the probability of poor parent ratings of care across the four racial/ethnic/language subgroups (p>.20). A one standard deviation improvement in the doctor communication care experience was associated with about half the frequency of poor ratings of care for personal doctor and health care in all subgroups (p<.05). Sensitivity analysis of individual communication items found that failure to provide explanations to children predicted poor ratings of care only among whites, who also weighed the length of physician interaction more heavily than other subgroups.

Conclusions

Communication-based interventions may improve experiences and ratings of care for all subgroups, although implementation of these interventions may need to consider preferences associated with race, ethnicity, and language.

SUBMITTER: Wilkins V

PROVIDER: S-EPMC3097404 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

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Publications

The association between care experiences and parent ratings of care for different racial, ethnic, and language groups in a Medicaid population.

Wilkins Victoria V Elliott Marc N MN Richardson Andrea A Lozano Paula P Mangione-Smith Rita R

Health services research 20110128 3

<h4>Objective</h4>To examine the association between care experiences and parent ratings of care within racial/ethnic/language subgroups.<h4>Data source</h4>National Consumer Assessment of Healthcare Providers and Systems Benchmarking Database 3.0 (2003-2006). Sample Characteristics. 111,139 parents of minor Medicaid managed care enrollees.<h4>Study design</h4>Cross-sectional observational study predicting "poor" (0-5 on 0-10 scale) parent ratings of personal doctor, specialist, health care, and ...[more]

PMID: 21275987

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Project description:ImportanceMedicare Advantage (MA) plans, which disproportionately enroll racial/ethnic minorities and persons with socioeconomic disadvantage, receive bonus payments on the basis of overall performance on a 5-star rating scale. The association between plans' overall quality and disparities in quality is not well understood.ObjectiveTo examine the association between MA star ratings and disparities in care for racial/ethnic minorities and enrollees with lower income and educational attainment.Design setting and participantsThis cross-sectional study included 1 578 564 MA enrollees from 454 contracts across the 2015 and 2016 calendar years. Data analyses were conducted between June 2019 and June 2020.ExposuresSelf-reported race and ethnicity and low socioeconomic status (SES) (defined by low income or less than a high school education) vs high SES (neither low income nor low educational attainment).Main outcomes and measuresPerformance on 22 measures of quality and satisfaction determined at the individual enrollee level, aggregated into simulated star ratings (scale, 2-5) stratified by SES and race/ethnicity.ResultsA total of 1 578 564 enrollees were included in this analysis (55.8% female; mean [SD] age, 71.4 [11.3] years; 65.8% White; 12.3% Black; 14.6% Hispanic). Enrollees with low SES had simulated stratified star ratings 0.5 stars lower (95% CI, 0.4-0.6 stars) than individuals with high SES in the same contract. Black and Hispanic enrollees had simulated star ratings that were 0.3 stars (95% CI, 0.2-0.4 stars) and 0.1 stars (95% CI, -0.04 to 0.2 stars) lower than White enrollees within the same contracts. Black enrollees had a 0.4-star lower rating (95% CI, 0.1-0.7 stars) in 4.5- to 5-star contracts and a no statistical difference in 2.0- to 2.5-star-rated contracts (difference, 0.3 stars; 95% CI, -0.02 to 0.7 stars). Hispanic enrollees had a 0.6-star lower simulated rating (95% CI, 0.2-1.0 stars) in 4.5- to 5-star contracts and no statistical difference in 2- to 2.5-star contracts (difference, -0.01 stars; 95% CI, -0.5 to 0.4 stars). There was low correlation between simulated ratings for enrollees of low SES and high SES (difference, 0.2 stars; 95% CI, 0.03-0.4 stars) and between simulated ratings for White and Black enrollees (difference, 0.4 stars; 95% CI, 0.3-0.5 stars) and White and Hispanic enrollees (difference, 0.3 stars; 95% CI, 0.2-0.4 stars). As the proportion of Black and Hispanic enrollees increased in a contract, racial/ethnic disparities in ratings decreased.Conclusions and relevanceIn this cross-sectional study, simulated MA star ratings were only weakly correlated with those for enrollees of low SES in the same contract, and contracts with higher star ratings had larger disparities in quality. Measures of equity in MA plans' quality of care may be needed.

Dataset Information

The association between care experiences and parent ratings of care for different racial, ethnic, and language groups in a Medicaid population.

Objective

Data source

Study design

Principal findings

Conclusions

Publications

The association between care experiences and parent ratings of care for different racial, ethnic, and language groups in a Medicaid population.

Similar Datasets

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