The Effect Modification of Supplemental Insurance on the Relationship Between Race and Bone Mineral Density Screening in Female Medicare Beneficiaries
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To determine the effect modification of supplemental insurance on the relationship between race and bone mineral density (BMD) in female Medicare beneficiaries. Retrospectively analyzing hospital administrative claim and clinical data of female Medicare beneficiaries (n = 1,398), we performed multivariate logistic regressions of BMD testing including data from all study participants and the subsets of health insurance. Significantly fewer Black than White female Medicare beneficiaries received the BMD testing in the overall sample (odds ratio, OR = 0.63; p = 0.02) and those without supplementary health insurance (n = 709; OR = 0.38; p = 0.004). By contrast, the magnitude of this racial disparity in the BMD testing was diminished among those with supplementary private health insurance (n = 689). We found a significant racial disparity in BMD testing for Black and White female Medicare beneficiaries. This disparity became more pronounced among those without supplementary private health insurance.
KeywordsBone mineral density Accessibility of health services Health Insurance for aged and disabled Women’s health service
All authors disclose NO financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. This project was supported by the American Geriatrics Society Seed Grant Research Program. The funding source had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. We thank Pil Park, PhD (University of Michigan Medical School) and Daehyun Kim, M.D., M.P.H. (Harvard Medical School) for their precious feedbacks on study design, analysis interpretation, and manuscript preparation.
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