Minorities more likely than whites to get 'low-value' health care

  • Blacks and Hispanics often get less effective health care than whites.
  • A new report finds they often get more unnecessary and economically inefficient care.
  • While 5 percent of white Medicare patients with dementia received a feeding tube, 17 percent of blacks and 13 percent of Hispanics did.
A woman who said she had a pre-existing condition that made it impossible to find insurance that would cover her until the Affordable Care Act, is examined by a doctor during a routine checkup at a community health clinic in Miami, Florida.
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Minorities are facing possible "double jeopardy" when it comes to their health: getting both less effective treatment and more treatment that has little value to them.

A new study released Monday finds that blacks and Hispanics are more likely than whites to get so-called low-value health care.

The report, published in the journal Health Affairs, noted that research has long shown that blacks and Hispanics, as groups, tend to receive "fewer effective services" such as cancer screenings and diabetes monitoring than white people do. Those are the kinds of services known to do a good job at helping people live healthier, longer lives.

But it also turns out that minorities get more health tests and treatments that have been identified as "unnecessary and economically inefficient," as well as "potentially harmful" in many cases, the study said.

"Common examples include inappropriate imaging for low-back pain, cervical cancer screening in women older than age sixty-five, and the use of antibiotics," the report said.

Researchers relied on Medicare data from 2006 through 2011 that showed black and Hispanic beneficiaries often received higher amounts of such low-value care than white beneficiaries did.

"Most notably, black and Hispanic patients with dementia faced significantly greater odds of inappropriately receiving feeding tubes, compared to white patients," the report said.

Less than 5 percent of white Medicare patients with dementia received a feeding tube. That compares to more than 17 percent of black patients and 13 percent of Hispanic patients with dementia, according to the authors.

And while about 33 percent of black beneficiaries received opioid or butalbital prescriptions for migraines, fewer than 25 percent of white beneficiaries received such prescriptions.

"Black and Hispanic beneficiaries were also significantly more likely to receive unnecessary cardiac screening and preoperative testing, among other forms of low-value care," the report said.

For example, more than 16 percent of Hispanics received bone density testing, compared to fewer than 10 percent of whites.

"Our findings suggest a possible double jeopardy for minority patients: Long understood to be at risk of receiving less effective care, they also appear to be often at risk of receiving more ineffective care," the report said.

The authors also said that understanding the differences in how health care is prescribed for people of different racial and ethnic groups "should inform policies aimed at addressing health care disparities, including the design of payer performance metrics."

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