Performance Improvement 2004. Longitudinal Study of Ischemic Heart Disease Among Aged Medicare Beneficiaries


This project assessed the use of Medicare covered services among Medicare beneficiaries with ischemic heart disease based on sociodemographic characteristics (e.g., race/ethnicity, sex, age, socioeconomic status). It was one part of a larger CMS and Department of Health and Human Services effort to address health disparities among Medicare beneficiaries. This was done using a longitudinal database that linked Medicare enrollment and claims data with small-area geographic data on income (e.g., U.S. Census data). Due to recent change in the race/ethnic coding in the Medicare enrollment database (EDB), it was not possible to examine health care access, utilization, and outcomes among minority groups. Some key findings indicate that (1) the lower rates of complex diagnostic testing and reperfusion therapies for Blacks compared to Whites. Much less research was published on other minorities besides Blacks and, when available, produced conflicting findings. For example, some studies found Hispanics less likely than Whites to undergo open heart surgery while others found no such differences. (2) Also, rural location and poverty area residence have both been linked to lower use rates among Blacks. Minorities may have less access to costly high-tech procedures because they cannot afford them. (3) Controlling for socioeconomic status, research has shown that Blacks are often treated differently in the same hospital and are less often referred for cardiac catheterization or to a specialist.

PIC ID: 7419
Agency Sponsor: CMS, Centers for Medicare and Medicaid Services
Federal Contact: Meltzer, Arthur, 410-786-9974
Performer: Research Triangle Institute, Research Triangle Park, NC

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