Do Black elderly Medicare patients receive fewer services? An analysis of procedure use for selected patient conditions

Blacks have been shown to undergo fewer medical procedures than Whites, particularly for coronary disease. This article uses logistic regression to analyze racial disparities in procedure use among older Medicare enrollees admitted for coronary artery disease, stroke, hip fracture, and colon and breast cancer. Medicare enrollment and claims data are used to identify hospitalizations and procedure use, and to measure other individual level information. No racial differences in procedure use are found for hip fracture and colon/breast cancer patients, life-threatening diseases for which basic approaches to evaluation and treatment are widely accepted. Substantial differences, however, are found for coronary disease and stroke, two illnesses whose treatment involves substantially greater discretion.