2009-2017 RACIAL AND ETHNIC DISPARITIES IN MEDICARE PATIENT EXPERIENCE AND INFLUENZA IMMUNIZATION

Abstract

We sought to understand the extent to which racial and ethnic disparities in the immunization rates and case-mix adjusted patient experiences of access (getting needed care and getting care quickly) of Black, Hispanic, and non-Hispanic White Medicare beneficiaries have changed over time. Accordingly, we analyzed 2009-2017 CAHPS data from 2,725,614 Medicare beneficiaries. In 2009, flu immunization rates for Black and Hispanic beneficiaries were lower than non-Hispanic White beneficiaries by 17 and 14 percentage points, respectively. Over 9 years, these gaps were reduced to 12 and 8 points, respectively (p<.01 for all comparisons). In 2009, Black beneficiaries had 2-point and 5-point disparities on getting needed care and getting care quickly (on a 0-100 scale) respectively, relative to non-Hispanic Whites. For getting needed care, there was no significant change over time in the gap between Blacks and non-Hispanic Whites. For getting care quickly, the gap between Blacks and non-Hispanic Whites narrowed to 3 points in 2017. In 2009, Hispanic beneficiaries had 2-point and 5-point disparities on getting needed care and getting care quickly, respectively, compared to non-Hispanic Whites. The gap on getting needed care widened by 1 point to a 2017 disparity of 3 points. For getting care quickly, there was no significant change over time in the gap between Hispanics and non-Hispanic Whites. These findings suggest that flu immunization rates for Black and Hispanic Medicare beneficiaries have improved significantly relative to non-Hispanic Whites; however, substantial disparities remain. For the patient experience measures, the findings are more mixed.