The 130th Annual Meeting of APHA

Abstract #42509

Robert Weech-Maldonado, PhD¹, Leo S. Morales, MD, PhD², Marc Elliott, MA, PhD³, Karen Spritzer, BA⁴, Grant Marshall, PhD³, and Ron D. Hays, PhD⁵. (1) Health Policy & Administration, Pennsylvania State University, 116 Henderson Building, University Park, PA 16801, (814) 865-1926, rxw25@psu.edu, (2) Division of GIM & Health Services Research, UCLA School of Medicine, 911 Broxton Plaza, Room 110, Los Angeles, CA 90095-1736, (3) RAND, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407, (4) Division of General Internal Medicine and Health Services Research, UCLA School of Medicine, 911 Broxton Avenue, Los Angeles, CA 90095, (5) Medicine, University of California, Los Angles, 911 Broxton Plaza, Box 951736, Los Angeles, CA 90095-1736

Consumer assessments of health care are increasingly being used as an indicator of the quality of care provided by health plans and providers. The purpose of this study was to examine whether consumer reports and ratings of care in Medicaid managed care vary by race/ethnicity and language. Data analyzed are from the National CAHPS® Benchmarking Database (NCBD) 3.0. Data were collected by telephone and mail, and surveys were administered in Spanish and English. The sample consisted of 42,542 adults and 39,284 children enrolled in Medicaid managed care plans in 14 states from 1999 to 2000. Data were analyzed using linear regression models. The dependent variables are CAHPS® 2.0 global rating items (personal doctor, specialist, health care, health plan) and multi-item reports of care (getting needed care, timeliness of care, provider communication, staff helpfulness, plan service). The independent variables are race/ethnicity (White, African American, Asian, Pacific Islander, American Indian, White/American Indian, White/African American, Hispanic, and Other) and language spoken (English, Spanish, Bilingual -English/Spanish, and Other), controlling for gender, age, education, and health status. This study suggests that racial/ethnic and limited English speaking minorities face barriers to care, even after Medicaid has assured financial access. Race/ethnicity and language have independent negative associations with reports and ratings of care. However, language has a stronger negative effect on reports of care than race/ethnicity. Health care organizations should address the observed disparities in access to care for racial/ethnic and linguistic minorities as part of their quality improvement efforts.

Learning Objectives:

• To understand the role of consumer assessments of health care in quality assessment.
• To analyze the impact of race/ethnicity and language on consumer reports and ratings of care.
• To discuss the importance for health care organizations to develop culturally and linguistically appropriate systems of care.

Keywords: Access to Health Care, Medicaid Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.