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The Validity of Race and Ethnicity in Enrollment Data for Medicare Beneficiaries
Author(s) -
Zaslavsky Alan M.,
Ayanian John Z.,
Zaborski Lawrence B.
Publication year - 2012
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2012.01411.x
Subject(s) - ethnic group , medicine , health care , demography , health equity , race (biology) , population , data collection , gerontology , public health , environmental health , nursing , statistics , botany , sociology , anthropology , economics , biology , economic growth , mathematics
Objective To assess the validity of race/ethnicity in M edicare databases for studies of racial/ethnic disparities. Data Sources The 2010 M edicare C onsumer A ssessments of H ealthcare P roviders and S ystems ( CAHPS ® ) survey was linked to M edicare enrollment data and local area characteristics from the 2000 C ensus. Study Design Race/ethnicity was cross‐tabulated for CAHPS and M edicare data. Within each self‐reported category, demographic, geographic, health, and health care variables were compared between those that were and were not similarly identified in M edicare data. Data Collection Methods The Medicare CAHPS survey included 343,658 responses from elderly participants (60 percent response rate). Data were weighted for sampling and nonresponse to be representative of the national population of elderly M edicare beneficiaries. Principal Findings Self‐reported H ispanics, A sians, P acific I slanders, and A merican I ndians were underidentified in M edicare enrollment data. Individuals in these groups who were identified in M edicare data tended to be more strongly identified with their group, poorer, and in worse health and to report worse health care experiences than those who were not so identified. Conclusions Self‐reported members of racial and ethnic groups other than Whites and Blacks who are identified in M edicare data differ substantially from those who are not so identified. These differences should be considered in assessments of disparities in health and health care among M edicare beneficiaries.