PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of hsresearchLink to Publisher's site
 
Health Serv Res. 1998 October; 33(4 Pt 1): 867–890.
PMCID: PMC1070291

The demand for healthcare among racial/ethnic subpopulations.

Abstract

OBJECTIVE: To analyze differences in the determination of healthcare expenditures among racial/ethnic groups. DATA SOURCE: The 1987 National Medical Expenditure Survey, a nationally representative sample of the United States population. (Nomenclature reflects racial/ethnic categories as used in the Survey.) STUDY DESIGN: The design was to estimate completely separate demand systems for blacks, Hispanics, and whites, perform statistical tests for the appropriateness of such separation, and carry out various simulations of healthcare expenditures. DATA COLLECTION/EXTRACTION METHODS: All black, white, and Hispanic persons in the 1987 NMES Household Survey were used in this analysis. PRINCIPAL FINDINGS: Several of the differences among the equations for the three racial/ethnic groups appear to be related to access to care, particularly between Hispanics and whites, and to a lesser degree between blacks and whites. Simulations indicated that most of the differences in healthcare spending were due on net to differences in characteristics of the sampled persons and their environments. However, for Hispanics relative to both blacks and whites, some of the differences in total expenditures were also due to differences in the behavior embodied in the equations. CONCLUSIONS: It would be inadequate, and possibly misleading, to allow for differences in health expenditures by simply including dummy variables for blacks, Hispanics, and/or whites in pooled equations estimated for the entire sample. Studies that allow one to analyze the institutional and behavioral aspects of healthcare spending in greater detail are needed for a better understanding of these racial/ethnic differences.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ford E, Cooper R, Castaner A, Simmons B, Mar M. Coronary arteriography and coronary bypass survey among whites and other racial groups relative to hospital-based incidence rates for coronary artery disease: findings from NHDS. Am J Public Health. 1989 Apr;79(4):437–440. [PubMed]
  • Garrett JM, Harris RP, Norburn JK, Patrick DL, Danis M. Life-sustaining treatments during terminal illness: who wants what? J Gen Intern Med. 1993 Jul;8(7):361–368. [PubMed]
  • Johnson PA, Lee TH, Cook EF, Rouan GW, Goldman L. Effect of race on the presentation and management of patients with acute chest pain. Ann Intern Med. 1993 Apr 15;118(8):593–601. [PubMed]
  • LaVeist TA. Beyond dummy variables and sample selection: what health services researchers ought to know about race as a variable. Health Serv Res. 1994 Apr;29(1):1–16. [PMC free article] [PubMed]
  • Mort EA, Weissman JS, Epstein AM. Physician discretion and racial variation in the use of surgical procedures. Arch Intern Med. 1994 Apr 11;154(7):761–767. [PubMed]
  • Nickens HW. The role of race/ethnicity and social class in minority health status. Health Serv Res. 1995 Apr;30(1 Pt 2):151–162. [PMC free article] [PubMed]
  • Schulman KA, Rubenstein LE, Chesley FD, Eisenberg JM. The roles of race and socioeconomic factors in health services research. Health Serv Res. 1995 Apr;30(1 Pt 2):179–195. [PMC free article] [PubMed]
  • Schur CL, Bernstein AB, Berk ML. The importance of distinguishing Hispanic subpopulations in the use of medical care. Med Care. 1987 Jul;25(7):627–641. [PubMed]
  • Wells KB, Golding JM, Hough RL, Burnam MA, Karno M. Acculturation and the probability of use of health services by Mexican Americans. Health Serv Res. 1989 Jun;24(2):237–257. [PMC free article] [PubMed]
  • Wenneker MB, Epstein AM. Racial inequalities in the use of procedures for patients with ischemic heart disease in Massachusetts. JAMA. 1989 Jan 13;261(2):253–257. [PubMed]
  • Wilson PA, Griffith JR, Tedeschi PJ. Does race affect hospital use? Am J Public Health. 1985 Mar;75(3):263–269. [PubMed]
  • Wolinsky FD, Aguirre BE, Fann LJ, Keith VM, Arnold CL, Niederhauer JC, Dietrich K. Ethnic differences in the demand for physician and hospital utilization among older adults in major American cities: conspicuous evidence of considerable inequalities. Milbank Q. 1989;67(3-4):412–449. [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust