Is patient HMO insurance or physician HMO participation related to racial disparities in primary care?

Kevin Fiscella, Peter Franks

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To examine the relationship between racial disparities in common primary care procedures and patient HMO membership and physician level of HMO participation. Design: Cross-sectional analysis. Methods: Data were obtained from a nationally representative sample of primary care office visits documented in the National Ambulatory Medical Care Survey for 1985, 1989-1992, and 1997-2000. Patient HMO membership was assessed based on reports by primary care physicians (defined as family physicians/general practitioners, internists, or obstetrician-gynecologists). Physician HMO participation was assessed based on the proportion of the physician's patients who were in an HMO. Patient characteristics (age, sex, race, insurance, diagnoses) and office procedures or interventions were determined by examining the physician report. Patients were adults aged 19 years or older. Results: In adjusted analyses, African Americans, compared with whites, had lower odds of receiving a Pap test (adjusted odds ratio [AOR] = 0.76; 95% confidence interval [CI] = 0.65, .90), a rectal exam (AOR = 0.67; 95% CI = 0.54, 0.84), smoking cessation advice (AOR = 0.72; 95% CI = 0.58, 0.91), and mental health advice (AOR = 0.4.6; 95% CI = 0.29, 0.72), but had higher odds of receiving advice on diet and weight, and a follow-up appointment. Notably, there were no significant interactions between either patient HMO membership or physician level of HMO participation, patient race, and receipt of primary care services. Conclusion: Neither patient HMO membership nor physician level of HMO participation is substantially associated with racial disparities in primary care.

Original languageEnglish (US)
Pages (from-to)397-402
Number of pages6
JournalAmerican Journal of Managed Care
Volume11
Issue number6
StatePublished - Jun 2005

Fingerprint

Health Maintenance Organizations
Insurance
insurance
Primary Health Care
physician
Physicians
participation
confidence
Odds Ratio
Confidence Intervals
family physician
general practitioner
Health Care Surveys
Patient Participation
Papanicolaou Test
Office Visits
medical care
smoking
Family Physicians
Primary Care Physicians

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Is patient HMO insurance or physician HMO participation related to racial disparities in primary care? / Fiscella, Kevin; Franks, Peter.

In: American Journal of Managed Care, Vol. 11, No. 6, 06.2005, p. 397-402.

Research output: Contribution to journalArticle

@article{7aaf9aef7caf4f91b3063b385be33e18,
title = "Is patient HMO insurance or physician HMO participation related to racial disparities in primary care?",
abstract = "Objective: To examine the relationship between racial disparities in common primary care procedures and patient HMO membership and physician level of HMO participation. Design: Cross-sectional analysis. Methods: Data were obtained from a nationally representative sample of primary care office visits documented in the National Ambulatory Medical Care Survey for 1985, 1989-1992, and 1997-2000. Patient HMO membership was assessed based on reports by primary care physicians (defined as family physicians/general practitioners, internists, or obstetrician-gynecologists). Physician HMO participation was assessed based on the proportion of the physician's patients who were in an HMO. Patient characteristics (age, sex, race, insurance, diagnoses) and office procedures or interventions were determined by examining the physician report. Patients were adults aged 19 years or older. Results: In adjusted analyses, African Americans, compared with whites, had lower odds of receiving a Pap test (adjusted odds ratio [AOR] = 0.76; 95{\%} confidence interval [CI] = 0.65, .90), a rectal exam (AOR = 0.67; 95{\%} CI = 0.54, 0.84), smoking cessation advice (AOR = 0.72; 95{\%} CI = 0.58, 0.91), and mental health advice (AOR = 0.4.6; 95{\%} CI = 0.29, 0.72), but had higher odds of receiving advice on diet and weight, and a follow-up appointment. Notably, there were no significant interactions between either patient HMO membership or physician level of HMO participation, patient race, and receipt of primary care services. Conclusion: Neither patient HMO membership nor physician level of HMO participation is substantially associated with racial disparities in primary care.",
author = "Kevin Fiscella and Peter Franks",
year = "2005",
month = "6",
language = "English (US)",
volume = "11",
pages = "397--402",
journal = "American Journal of Managed Care",
issn = "1088-0224",
publisher = "Ascend Media",
number = "6",

}

TY - JOUR

T1 - Is patient HMO insurance or physician HMO participation related to racial disparities in primary care?

AU - Fiscella, Kevin

AU - Franks, Peter

PY - 2005/6

Y1 - 2005/6

N2 - Objective: To examine the relationship between racial disparities in common primary care procedures and patient HMO membership and physician level of HMO participation. Design: Cross-sectional analysis. Methods: Data were obtained from a nationally representative sample of primary care office visits documented in the National Ambulatory Medical Care Survey for 1985, 1989-1992, and 1997-2000. Patient HMO membership was assessed based on reports by primary care physicians (defined as family physicians/general practitioners, internists, or obstetrician-gynecologists). Physician HMO participation was assessed based on the proportion of the physician's patients who were in an HMO. Patient characteristics (age, sex, race, insurance, diagnoses) and office procedures or interventions were determined by examining the physician report. Patients were adults aged 19 years or older. Results: In adjusted analyses, African Americans, compared with whites, had lower odds of receiving a Pap test (adjusted odds ratio [AOR] = 0.76; 95% confidence interval [CI] = 0.65, .90), a rectal exam (AOR = 0.67; 95% CI = 0.54, 0.84), smoking cessation advice (AOR = 0.72; 95% CI = 0.58, 0.91), and mental health advice (AOR = 0.4.6; 95% CI = 0.29, 0.72), but had higher odds of receiving advice on diet and weight, and a follow-up appointment. Notably, there were no significant interactions between either patient HMO membership or physician level of HMO participation, patient race, and receipt of primary care services. Conclusion: Neither patient HMO membership nor physician level of HMO participation is substantially associated with racial disparities in primary care.

AB - Objective: To examine the relationship between racial disparities in common primary care procedures and patient HMO membership and physician level of HMO participation. Design: Cross-sectional analysis. Methods: Data were obtained from a nationally representative sample of primary care office visits documented in the National Ambulatory Medical Care Survey for 1985, 1989-1992, and 1997-2000. Patient HMO membership was assessed based on reports by primary care physicians (defined as family physicians/general practitioners, internists, or obstetrician-gynecologists). Physician HMO participation was assessed based on the proportion of the physician's patients who were in an HMO. Patient characteristics (age, sex, race, insurance, diagnoses) and office procedures or interventions were determined by examining the physician report. Patients were adults aged 19 years or older. Results: In adjusted analyses, African Americans, compared with whites, had lower odds of receiving a Pap test (adjusted odds ratio [AOR] = 0.76; 95% confidence interval [CI] = 0.65, .90), a rectal exam (AOR = 0.67; 95% CI = 0.54, 0.84), smoking cessation advice (AOR = 0.72; 95% CI = 0.58, 0.91), and mental health advice (AOR = 0.4.6; 95% CI = 0.29, 0.72), but had higher odds of receiving advice on diet and weight, and a follow-up appointment. Notably, there were no significant interactions between either patient HMO membership or physician level of HMO participation, patient race, and receipt of primary care services. Conclusion: Neither patient HMO membership nor physician level of HMO participation is substantially associated with racial disparities in primary care.

UR - http://www.scopus.com/inward/record.url?scp=21044433752&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21044433752&partnerID=8YFLogxK

M3 - Article

VL - 11

SP - 397

EP - 402

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

IS - 6

ER -