Kevin Fiscella|Kathleen Holt
Impact of Primary Care Patient Visits on Racial and Ethnic Disparities in Preventive Care in the United States
University of Rochester|University of Rochester
backgroundthe causes racial ethnic disparities preventive care fully understoodwe examined hypothesis fewer primary care visits minority patients contribute disparitiesmethods analyzed claims medicare beneficiaries 65 older participated medicare current beneficiary survey 1998 2002five preventive services included colorectal cancer testing influenza vaccination lipid screening mammography papanicolaou smear screeningin separate multivariate analyses examined effect minority status selfreport african american race hispanic ethnicity claim past 12 months preventive service successive control number primary care visits patient characteristicsresults final sample included 15962 subjectsin ageadjusted analyses minorities statistically lower rates claims 5 proceduresafter controlling number primary care visits effect minority status slightly attenuated remained statistically significant receipt procedureafter adding low income low educational level supplementary insurance health status year minority status significantly associated colorectal cancer screening odds ratio 079 95 confidence interval ci 067 094 influenza vaccinations 056 95 ci 049 064conclusions frequency primary care visits seems contribute minimally racial ethnic disparities preventive servicesother patient characteristics particularly associated poverty explain much disparities