Background In the United States, black patients generally receivelower-quality health care than white patients. Black patientsmay receive their care from a subgroup of physicians whose qualificationsor resources are inferior to those of the physicians who treatwhite patients.
Methods We performed a cross-sectional analysis of 150,391 visitsby black Medicare beneficiaries and white Medicare beneficiaries65 years of age or older for medical "evaluation and management"who were seen by 4355 primary care physicians who participatedin a biannual telephone survey, the 2000–2001 CommunityTracking Study Physician Survey.
Results Most visits by black patients were with a small groupof physicians (80 percent of visits were accounted for by 22percent of physicians) who provided only a small percentageof care to white patients. In a comparison of visits by whitepatients and black patients, we found that the physicians whomthe black patients visited were less likely to be board certified(77.4 percent) than were the physicians visited by the whitepatients (86.1 percent, P=0.02) and also more likely to reportthat they were unable to provide high-quality care to all theirpatients (27.8 percent vs. 19.3 percent, P=0.005). The physicianstreating black patients also reported facing greater difficultiesin obtaining access for their patients to high-quality subspecialists,high-quality diagnostic imaging, and nonemergency admissionto the hospital.
Conclusions Black patients and white patients are to a largeextent treated by different physicians. The physicians treatingblack patients may be less well trained clinically and may haveless access to important clinical resources than physicianstreating white patients. Further research should be conductedto address the extent to which these differences may be responsiblefor disparities in health care.
The elimination of racial and ethnic disparities in health careis one of the two goals of the initiative Healthy People 2010(the other being to increase the quality and years of healthylife), but the causes underlying these disparities have notbeen established.1 Because patients who are members of minoritygroups and white patients to some extent reside in differentlocations and seek their care in different settings, it is possiblethat doctors who treat these patients may differ with regardto both their clinical qualifications and their clinical resources.We hypothesized that such discrepancies account for the pervasivenessof racial and ethnic disparities in health care.
Several studies support this hypothesis. In a study of primarycare physicians in New York City comparing physicians who hadpatient panels in which less than 50 percent were members ofminority groups with physicians whose patient panels includedmore than 50 percent minority-group patients, Gemson et al.found that those who treated a greater proportion of minority-grouppatients were less knowledgeable about preventive care practicesand less likely to be board certified.2,3 Schneider et al.,in a study of managed-care plans, observed that physicians workingfor plans in which black patients were heavily enrolled providedprimary care of a lower quality to all patients in the planthan did physicians working for plans in which fewer black patientswere enrolled.4 Differences in qualifications and competencybetween physicians treating black patients and those treatingwhite patients have also been described with regard to cardiovascularsurgery and the care of patients infected with the human immunodeficiencyvirus.5,6
We studied a nationally representative sample of primary carephysicians who treated patients enrolled in Medicare, the nation'slargest health insurance plan. We focused on primary care physicians,because they are largely responsible for the coordination ofcare, often counsel patients regarding the need for referralsto specialists and for diagnostic tests and therapies, and providecontinuity of care for many patients with complex diseases.Studies have suggested that poor performance by physicians inthese domains may lead to disparities in preventive care, evaluationof symptoms, treatment, and outcome.7,8,9,10,11,12,13
Methods
Data
We combined data from two main sources in order to investigatethe relation of primary care physicians' training and resourcesto the race of patients to whom they provide "evaluation andmanagement" services.
Data on Physicians
The Community Tracking Study Physician Survey is a biannualtelephone survey conducted by the Center for Studying HealthSystem Change of a nationally representative sample of physicianswho are not federally employed. The survey is conducted in 60randomly selected metropolitan statistical areas and is supplementedby a national sample. In 2000–2001 (round 3 of the survey),the response rate among physicians was 59 percent. Details ofthe survey are available at www.hschange.org/index.cgi?data=04;many of the findings have been described previously.14,15,16,17The survey included only physicians who reported providing atleast 20 hours per week of direct patient care in an office-basedor hospital-based practice, including at sites of the Bureauof Primary Health Care of the Department of Health and HumanServices. Residents and fellows were excluded. Our study includedthe participating physicians whose primary specialty was familypractice or general practice, general internal medicine, orgeriatrics (which we subsumed under the category of internalmedicine).
Data on Patient Visits
The Medicare program provides health insurance for 97 percentof Americans who are 65 years of age or older. In 2001, theprogram covered 40 million persons, 86 percent of whom wereenrolled under Part A and Part B indemnity insurance (fee forservice), in which providers submit detailed claims to the Centersfor Medicare and Medicaid Services for reimbursement for servicesrendered.18 Data were obtained from the 2001 "5 percent carrierfile," which contains claims histories of a representative sampleof 5 percent of Medicare beneficiaries. We analyzed line itemsfor "evaluation and management" that were identified accordingto the Berenson–Eggers Type of Service Codes used by Medicare:M1A (office visits — new patient), M1B (office visits— established patient), and M6 (consultations), but weexcluded items with the Healthcare Common Procedure Coding Systemcodes 99381, 99411, 95115, 99391, 95117, 99236, 99262, 99251,99255, 99261, 99254, G0175, 99253, and 99252. (Information aboutthe codes is available at www.cms.hhs.gov/data/betos.19) Welimited our analysis to data on black Medicare beneficiariesand white Medicare beneficiaries (as documented in Medicarefiles) 65 years of age or older. Other racial or ethnic categoriesincluded in the Medicare data — Hispanic, Asian, NorthAmerican Native, other, and unknown — are less well studiedand less reliable.20,21,22,23
Linkage of Data
Data on physicians and patient visits were linked with the useof the physicians' unique provider identification number, whichis recorded on claims submitted to Medicare.24 Of 5859 primarycare physicians who were interviewed by telephone as part ofthe Community Tracking Study Physician Survey, 5627 (96.0 percent)had a unique provider identification number. Of these physicians,729 (13.0 percent) were not associated with claims that appearedin the 2001 Medicare 5 percent carrier file, and 543 (9.6 percent)were associated only with claims that were ineligible for ourstudy — for services other than evaluation and management,or for services rendered to patients who were not black or whiteand 65 years of age or older. A total of 4355 physicians (77.4percent) and 43,032 patients were included in our study, andtogether they contributed 44,756 unique physician–patientpairs (a few patients saw more than one physician included inour study) and 150,391 visits to our analysis. The number ofvisits per physician ranged from 1 to 304 (median, 24; interquartilerange, 10 to 48). These data were used to derive national estimatesthat reflected the characteristics of 87,803 primary care physiciansand of the 58 million visits (by 54 million white patients and4 million black patients) for evaluation and management thatthese physicians provided to black and white Medicare beneficiaries65 years of age or older in the United States in 2001.
Characteristics of Primary Care Physicians
On the basis of their responses to the Community Tracking StudyPhysician Survey, physicians were characterized according totheir demographic characteristics, setting of the practice andmix of payers, medical education, specialty, whether or notthey were board certified, and ability to provide access tonecessary health care resources for their patients. The demographiccharacteristics included age, sex, and self-declared race orethnic background. Information on payer mix and practice settingwas based on the reported percentage of revenue the practicederived from Medicare, Medicaid, and managed-care plans, thenumber and specialties of the physicians in the practice, whetheror not physicians provided care for which they received reducedcompensation or no compensation ("charity" care), location inan urban area (00-03) or a rural area (04-09), according tometropolitan statistical area codes in the Area Resource File,25and the income level in the area where the practice was located,according to data from the Census Bureau for 2000 on the medianincome within the area of a ZIP Code. The site of the physicians'medical education was dichotomized as either the United States,including Puerto Rico, or elsewhere. Board certification wasdetermined for the physicians' primary specialty. Data on eachof these measures were missing for less than 1 percent of physicians.
To gain insight into the ability of physicians in the studyto provide access to resources for their patients, we analyzedphysicians' responses to five questions in the following form:"How often are you able to obtain access for your patients to[type of service] when you think it is necessary?" The fivetypes of service were "subspecialists of high quality," "ancillaryservices of high quality," "nonemergency hospital admissions,""adequate number of inpatient days," and "high-quality diagnosticimaging." The physicians could respond "always," "almost always,""frequently," "sometimes," "rarely," and "never." On the basisof the distribution of the responses, and on our belief thatproviding high-quality care requires reliable access to suchservices, we dichotomized the responses into "always" (in which"always" and "almost always" were subsumed) or "not always"(in which the remaining responses were subsumed). Less than0.25 percent of the responses were missing or in a categorynot listed, such as "don't know," and were not included in theanalysis.
Physicians were asked to respond to two statements: "It is possibleto provide high-quality care to all my patients," and "The levelof communication I have with specialists about the patientsI refer to them is sufficient to ensure the delivery of high-qualitycare." We dichotomized the responses into "agree" (in which"strongly agree" and "somewhat agree" were subsumed) or "disagree"(in which "strongly disagree" and "somewhat disagree" were subsumed).Less than 3 percent of the responses were missing, "neitheragree nor disagree," or in a category not shown, such as "don'tknow"; these responses were not included in the analysis.
Statistical Analysis
The unit of analysis was the patient visit. For statisticalpurposes, the visits were nested within unique physician–patientpairs. Some patients saw more than one physician and thereforecontributed to more than one physician–patient pair. Manyphysicians were part of multiple physician–patient pairs,since they saw multiple patients (individual physicians whosaw both black patients and white patients are represented inthe counts of both visits by black patients and visits by whitepatients).
The distribution of visits by black patients and visits by whitepatients among physicians was estimated by means of logisticregression, with random effects for each physician, with theuse of SAS software (version 8.12). The estimated random effectswere used to calculate the proportion of black patients in eachphysician's Medicare patient panel. This approach was used tocorrect for sampling error.
The responses to the questions in the Community Tracking StudyPhysician Survey were evaluated with the use of SUDAAN software(version 7.0), to accommodate the multilevel design of the survey.26Associations between the patient's race and the physician'scharacteristics were analyzed with the use of unadjusted logisticregression, with the patient's race as the outcome. Associationsbetween the patient's race and the physician's self-reportsof access to resources were analyzed with the use of both unadjustedand adjusted logistic regression. In the primary analysis, therace of the patient was the outcome. In the secondary analysis,performed with the use of cumulative logistic regression, therace of the patient was the predictor and the physician's responseto the survey question was the ordered outcome.
In the adjusted analysis, we included measures of the payermix, with binary variables for the categories of charity careand urban or rural location and continuous variables for theproportion of revenue the practice derived from Medicare, Medicaid,and managed-care plans; median income within the area of theZIP Code of the practice; and the level of the availabilityof resources in the county in which the practice was located,according to the 2001 Area Resource File. For the analysis ofthe physicians' ability to gain access to specialists, the measureof available resources was the number of patient care surgeonsand medical subspecialists per capita. For the analysis of thephysicians' ability to gain access to nonemergency admissionand hospital days, the measure of available resources was thenumber of short-term hospital beds per capita. For the analysisof the physicians' ability to gain access to high-quality imaging,the measure of available resources was the number of patientcare radiologists per capita. In a separate analysis (data notshown), adjusted for the median income within the ZIP Code ofthe patient's residence rather than the ZIP Code of the physician'spractice, our findings were similar to those reported here.
To evaluate whether the characteristics of the population ofprimary care physicians in the geographic area where black patientsand white patients received care were similar to those of thephysicians who actually saw black patients and white patientsin that area, we analyzed data on physicians' characteristicswith the use of two geographic categories used in the DartmouthAtlas of Health Care project: the Hospital Service Area (a smallgeographic unit) and the Hospital Referral Region (a largergeographic unit) (information on these categories is availableat www.dartmouthatlas.org). We analyzed data on all physiciansincluded in our study and generated weighted averages of thesecharacteristics with respect to the geographic location of thevisits with black patients and white patients.
Our findings are reported after weighting, which was performedto render them nationally representative. All P values are two-sided.The study was approved by the Center for Medicare and MedicaidServices under Data Use Agreement number 12993. The institutionalreview board officer at Mathematica Policy Research who overseesthe conduct of the Community Tracking Study approved the confidentialityprovisions of our study and determined that the Medicare datalinkage did not violate the guidelines of the Community TrackingStudy.
Results
Distribution of Visits
The distribution of visits by Medicare patients who were whiteor black among primary care physicians is shown in Figure 1,ordered according to the proportion of black patients in eachphysician's practice. The height of the bars reflects the numberof visits by white patients and black patients. The cumulative-distributionLorenz curves indicate that the bulk of visits by black patientsare clustered among physicians whose patient panels includea higher percentage of blacks, whereas only a small percentageof visits by white patients are with these physicians. Visitsby white patients are mostly with physicians who provide onlya small amount of care to black patients. Of primary care physicians,78 percent (68,311 physicians) with a relatively small proportionof black patients in their practice account for 78 percent ofthe visits by white patients but only 20 percent of all visitsby black patients, whereas the remaining 22 percent of primarycare physicians (19,492) account for 80 percent of all visitsby black patients and 22 percent of visits by white patients.If visits by black patients and white patients were equallydistributed among physicians, the Lorenz curves in Figure 1would be superimposed on each other.
Figure 1. Estimated National Distribution of Visits to Primary Care Physicians by White Medicare Beneficiaries and Black Medicare Beneficiaries.
The physicians are shown in order of the proportions of their Medicare patients who are black, as opposed to white. The estimated number of visits by white patients (white hatched bars) and black patients (orange hatched bars) is indicated for each group of physicians, with the width of each bar encompassing 3600 physicians. The cumulative proportion of visits by white patients and by black patients is shown by the cumulative-distribution Lorenz curves. To the right of the vertical dashed line are the 19,492 primary care physicians (22 percent of all primary care physicians) who account for 80 percent of the visits by black Medicare patients and 22 percent of visits by white Medicare patients. To the left of that line are the 68,311 primary care physicians (78 percent of all primary care physicians) who account for 78 percent of all visits by white Medicare patients but only 20 percent of all visits by black Medicare patients.
Characteristics of Physicians
Both primary care physicians treating black patients and thosetreating white patients were typically near 50 years of age,male, non-Hispanic, and working in solo or two-physician practicesin an urban location (Table 1). Even though the majority ofvisits by both black patients (59.7 percent) and white patients(85.3 percent) were to white physicians, visits by black patientswere markedly more likely than visits by white patients to beto black physicians (22.4 percent vs. 0.7 percent). Physicianstreating black patients provided more charity care, deriveda higher percentage of their practice revenue from Medicaid,more often practiced in low-income neighborhoods, and were lesslikely to have obtained board certification in their primaryspecialty (77.4 percent vs. 86.1 percent, P=0.02) than physicianstreating white patients.
Table 1. Characteristics of Primary Care Physicians According to Visits by White and Black Medicare Beneficiaries.
Access to Important Health Care Services
The physicians' assessment of their ability to provide particularaspects of care to their patients also differed with respectto the race of the patient (Table 2). When physicians were askedif they were able to provide access to high-quality care forall of their patients, 27.8 percent of physicians treating blackpatients responded that they could not do so ("disagreed"),as compared with 19.3 percent of physicians treating white patients.They were also more likely than physicians treating white patientsto report that they could "not always" provide access for theirpatients to subspecialists of high quality (24.0 percent vs.17.9 percent), high-quality diagnostic imaging (24.4 percentvs. 16.6 percent), nonemergency hospital admissions (48.5 percentvs. 37.0 percent), and high-quality ancillary services (36.6percent vs. 27.7 percent). These findings were significant inboth unadjusted and adjusted analyses; the finding with regardto access to specialists was not significant in the cumulativelogistic-regression analysis (data not shown).
Table 2. Primary Care Physicians' Perceptions of the Quality of Care Provided in Relation to the Race of Patient.
Geographic Differences and Physicians' Characteristics
We assessed whether the differences between physicians treatingblack patients and those treating white patients were associatedwith the characteristics of physicians practicing in the geographicareas where black patients and white patients received theircare (Table 3). This type of geographic explanation of the qualityof health care has been explored in other studies of racialdifferences in health care.27,28
Table 3. Characteristics of Primary Care Physicians Who Treated White Patients and Those Who Treated Black Patients and of the Overall Population in the Areas Where Visits Occurred.
The degree of racial concordance between patient and physicianappeared greater than what would be expected if the local availabilityof physicians of different races were the only explanation ofthe matching of the patient's and physician's race (Table 3).Of visits by black patients in our study, 22.4 percent wereto physicians who were black, whereas in the Hospital ServiceAreas and Hospital Referral Regions, the percentage of blackphysicians was lower — 12.5 percent and 6.7 percent, respectively— a finding that supports the hypothesis that black patientspreferentially seek care from primary care physicians of theirown race.29,30
Other characteristics of the primary care physicians treatingwhite patients and those treating black patients were similarto the overall population of primary care physicians in thegeographic areas where the visits occurred. For example, 77.4percent of visits by black patients were to physicians who wereboard certified; the average rates of board certification inthe areas where the visits occurred were 77.7 percent accordingto the Hospital Service Area and 80.1 percent according to theHospital Referral Region.
Discussion
We evaluated the hypothesis that differences between primarycare physicians who treat black patients and those who treatwhite patients play a role in health care disparities. We foundthat visits by black patients were highly concentrated amonga small subgroup of primary care physicians, were more oftenwith physicians who were not board certified in their primaryspecialty, and were more often with physicians who reportedfacing obstacles in gaining access to high-quality servicesfor their patients. Each of these observations potentially hasimplications for disparities in health care.
In our study, the great majority of the visits by black patients(80 percent) were to a small group of primary care physicians(22 percent of the total), whereas the remaining physicians(78 percent) accounted for the majority of visits by white patients.This finding indicates that the care of black patients and whitepatients rests to a large extent in the hands of different physicians.Disparities in health care could emerge if these two groupsof physicians differed in their ability to provide high-qualitycare, either because of differences in their clinical trainingor because of differences in their access to resources. In addition,our study shows that it would be possible to identify physicianswho treat black patients or who treat white patients throughclaims databases.
The differences in the rates of board certification betweenthe two groups of physicians support the notion that the poorerquality of care received by black patients may in part resultfrom the fact that their physicians are less well trained thanthose who mostly treat white patients. For instance, the ratesof screening for most diseases are lower among black patientsthan among white patients, and black patients more often thanwhite patients receive diagnoses when diseases are at a relativelyadvanced stage. Previous research has shown that physicianswho scored poorly on their licensure examinations or who arenot board certified in their specialty are less likely to followscreening recommendations and more likely to prescribe symptom-directedtreatment, rather than diagnosis-directed treatment —tendencies that may result in delayed diagnoses.31,32,33,34,35
The differences in physicians' reported ease of access to servicesfor their patients point to additional mechanisms underlyinghealth care disparities. Differences in access to subspecialists,imaging studies, nonemergency hospital admission, and ancillaryservices might help explain why black patients see fewer subspecialistsand receive less timely treatment for complex chronic illnessesthan do white patients.36,37,38,39
Our findings should be interpreted within the context of thedata that we analyzed. The responses of physicians regardingaccess to resources are necessarily subjective and reflect thephysicians' experience with all their patients, not only withthe Medicare patients included in our analysis. Moreover, wecannot be certain of the extent to which differences in physicians'responses signify differences in the care that their patientsreceived, because we did not examine patients' outcomes. Wecould not consider the role of some other identified deficienciesin primary care of black patients. For example, predominantlyblack communities have fewer primary care doctors than predominantlywhite communities; black patients are more likely than whitepatients to receive care in inpatient and emergency-departmentsettings, rather than outpatient settings; and a larger fractionof visits for primary care by black patients are to physicianswith whom the patients do not have an established relationship.40,41,42
Because health care disparities are pervasive and because thedisparities are not due solely to differences in the patients'insurance coverage, hypotheses regarding the role of physiciansin their genesis have emerged. One hypothesis is that most physicians,because they are not black, lack the necessary cultural competenceneeded to treat black patients effectively.43 To redress thisproblem, many organizations have recommended that the physicianworkforce be enriched with more physicians who are members ofminority groups and that training in cultural competence bemandated.44 Our findings provide an indication of the extentto which black patients are currently receiving care from blackphysicians and of the extent to which these patients appearto make a special effort to do so.45,46,47,48,49
Without vitiating these hypotheses, our findings reveal otherimbalances in the health care system that may underlie disparitiesin the delivery of health care. Black patients in the Medicareprogram, and presumably other black patients as well, are treatedby a group of physicians who may differ in important ways fromthe physicians who treat white patients. That these differencesreflect characteristics of the physicians who practice whereblack persons and white persons receive care suggests that ourfindings are the result of the distribution of physicians inthe United States and not patients' choice. Further researchis needed to evaluate the extent to which differences in trainingand resources between physicians who treat black patients andphysicians who treat white patients affect patients' outcomes.Then, we could explore whether efforts to reduce disparitiesin the provision of health care should be focused on improvingthe care that physicians who treat black patients are able todeliver.
Supported by grants from the American Lung Association of NewYork City, the National Cancer Institute (K23CA86968 and RO1CA090226,to Dr. Bach), the American Cancer Society (RSGT-04-012-01-CPPB,to Dr. Schrag), and the Robert Wood Johnson Foundation for researchperformed at the Center for Studying Health System Change andfor support of analytic programming (to Drs. Pham and Hargraves).
We are indebted to the physician respondents to the CommunityTracking Study; to Colin B. Begg, Frank Potter, and Elyn Riedelfor statistical guidance; to Shannon S. Carson, Katrina Donahue,Beth Virnig, Paul B. Ginsburg, and Bob Konrad for helpful comments;and to Ellen Singer, Beny Wu, Cynthia Saiontz-Martinez, andGary Moore at Social & Scientific Systems (Silver Spring,Md.) for programming assistance.
Source Information
From the Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York (P.B.B., D.S., R.C.T.); and the Center for Studying Health System Change, Washington, D.C. (H.H.P., J.L.H.).
Address reprint requests to Dr. Bach at the Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., Box 221, New York, NY 10021.
References
Department of Health and Human Services. Healthy People 2010: understanding and improving health. 2nd ed. Washington, D.C.: Government Printing Office, November 2000.
Ashford A, Gemson D, Sheinfeld Gorin SN, et al. Cancer screening and prevention practices of inner-city physicians. Am J Prev Med 2000;19:59-62. [Medline]
Gemson DH, Elinson J, Messeri P. Differences in physician prevention practice patterns for white and minority patients. J Community Health 1988;13:53-64. [CrossRef][Medline]
Schneider EC, Zaslavsky AM, Epstein AM. Racial disparities in the quality of care for enrollees in Medicare managed care. JAMA 2002;287:1288-1294. [Free Full Text]
Mukamel DB, Murthy AS, Weimer DL. Racial differences in access to high-quality cardiac surgeons. Am J Public Health 2000;90:1774-1777. [Free Full Text]
Heslin K, Andersen RM, Ettner SL, Cunningham WE. Racial and ethnic differences in access to physicians with HIV-related expertise: findings from a nationally representative study. Presented at the Academy Health 20th Annual Research Meeting, Nashville, June 27–29, 2003. abstract.
van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care 2002;40:Suppl:I-140.
Ayanian JZ, Landrum MB, Guadagnoli E, Gaccione P. Specialty of ambulatory care physicians and mortality among elderly patients after myocardial infarction. N Engl J Med 2002;347:1678-1686. [Free Full Text]
Lurie N, Buntin MB. Health disparities and the quality of ambulatory care. N Engl J Med 2002;347:1709-1710. [Free Full Text]
Shi L, Starfield B, Politzer R, Regan J. Primary care, self-rated health, and reductions in social disparities in health. Health Serv Res 2002;37:529-550. [CrossRef][Web of Science][Medline]
Blumenthal D, Mort E, Edwards J. The efficacy of primary care for vulnerable population groups. Health Serv Res 1995;30:253-273. [Web of Science][Medline]
Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA 2000;283:2579-2584. [Free Full Text]
Shi L, Macinko J, Starfield B, Xu J, Politzer R. Primary care, income inequality, and stroke mortality in the United States: a longitudinal analysis, 1985-1995. Stroke 2003;34:1958-1964. [Free Full Text]
Landon BE, Reschovsky J, Blumenthal D. Changes in career satisfaction among primary care and specialist physicians, 1997-2001. JAMA 2003;289:442-449. [Free Full Text]
Landon BE, Reschovsky J, Reed M, Blumenthal D. Personal, organizational, and market level influences on physicians' practice patterns: results of a national survey of primary care physicians. Med Care 2001;39:889-905. [CrossRef][Web of Science][Medline]
St Peter RF, Reed MC, Kemper P, Blumenthal D. Changes in the scope of care provided by primary care physicians. N Engl J Med 1999;341:1980-1985. [Free Full Text]
Kemper P, Blumenthal D, Corrigan JM, et al. The design of the community tracking study: a longitudinal study of health system change and its effects on people. Inquiry 1996;33:195-206. [Web of Science][Medline]
2002 Data compendium. Baltimore: Centers for Medicare & Medicaid Services, 2002.
Physicians' current procedural terminology: CPT 1999. Chicago: American Medical Association, 1999.
Lauderdale DS, Goldberg J. The expanded racial and ethnic codes in the Medicare data files: their completeness of coverage and accuracy. Am J Public Health 1996;86:712-716. [Free Full Text]
Bach PB, Guadagnoli E, Schrag D, Schussler N, Warren JL. Patient demographic and socioeconomic characteristics in the SEER-Medicare database applications and limitations. Med Care 2002;40:Suppl:IV-19.
Arday SL, Arday DR, Monroe S, Zhang J. HCFA's racial and ethnic data: current accuracy and recent improvements. Health Care Financ Rev 2000;21:107-116. [Web of Science][Medline]
Aaron KF, Clancy CM. Improving quality and reducing disparities: toward a common pathway. JAMA 2003;289:1033-1034. [Free Full Text]
Baldwin L, Adamache W, Klabunde CN, Kenward K, Dahlman C, Warren JL. Linking physician characteristics and Medicare claims data: issues in data availability, quality, and measurement. Med Care 2002;40:Suppl:IV-82.
Best AE. Secondary data bases and their use in outcomes research: a review of the Area Resource File and the Healthcare Cost and Utilization Project. J Med Syst 1999;23:175-181. [CrossRef][Medline]
Shah BV, Barnwell BG, Bieler GS. SUDAAN user's manual, release 7.0. Research Triangle Park, N.C.: Research Triangle Institute, 1996.
Chandra A, Skinner J. Geography and racial health disparities. NBER working paper no. W9513. Cambridge, Mass.: National Bureau of Economic Research, February 2003.
Skinner J, Weinstein JN, Sporer SM, Wennberg JE. Racial, ethnic, and geographic disparities in rates of knee arthroplasty among Medicare patients. N Engl J Med 2003;349:1350-1359. [Free Full Text]
Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff (Millwood) 2000;19:76-83. [Abstract]
Laveist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav 2002;43:296-306. [CrossRef][Web of Science][Medline]
Ramsey PG, Carline JD, Inui TS, Larson EB, LoGerfo JP, Wenrich MD. Predictive validity of certification by the American Board of Internal Medicine. Ann Intern Med 1989;110:719-726. [Free Full Text]
Tamblyn R, Abrahamowicz M, Dauphinee WD, et al. Association between licensure examination scores and practice in primary care. JAMA 2002;288:3019-3026. [Free Full Text]
Norcini JJ, Lipner RS, Kimball HR. Certifying examination performance and patient outcomes following acute myocardial infarction. Med Educ 2002;36:853-859. [CrossRef][Web of Science][Medline]
Sharp LK, Bashook PG, Lipsky MS, Horowitz SD, Miller SH. Specialty board certification and clinical outcomes: the missing link. Acad Med 2002;77:534-542. [Web of Science][Medline]
Meyers DG, Steinle BT. Awareness of consensus preventive medicine practice guidelines among primary care physicians. Am J Prev Med 1997;13:45-50. [Medline]
Canto JG, Allison JJ, Kiefe CI, et al. Relation of race and sex to the use of reperfusion therapy in Medicare beneficiaries with acute myocardial infarction. N Engl J Med 2000;342:1094-1100. [Free Full Text]
Kinchen KS, Sadler J, Fink N, et al. The timing of specialist evaluation in chronic kidney disease and mortality. Ann Intern Med 2002;137:479-486. [Free Full Text]
Blustein J, Weiss LJ. Visits to specialists under Medicare: socioeconomic advantage and access to care. J Health Care Poor Underserved 1998;9:153-169. [Web of Science][Medline]
Bach PB, Cramer LD, Warren JL, Begg CB. Racial differences in the treatment of early-stage lung cancer. N Engl J Med 1999;341:1198-1205. [Free Full Text]
Komaromy M, Grumbach K, Drake M, et al. The role of black and Hispanic physicians in providing health care for underserved populations. N Engl J Med 1996;334:1305-1310. [Free Full Text]
Gornick ME, Eggers PW, Reilly TW, et al. Effects of race and income on mortality and use of services among Medicare beneficiaries. N Engl J Med 1996;335:791-799. [Free Full Text]
Williams RL, Flocke SA, Stange KC. Race and preventive services delivery among black patients and white patients seen in primary care. Med Care 2001;39:1260-1267. [CrossRef][Web of Science][Medline]
Smedley BD, Stith AY, Nelson AR, eds. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, D.C.: National Academy Press, 2003.
Cohen JJ, Gabriel BA, Terrell C. The case for diversity in the health care workforce. Health Aff (Millwood) 2002;21:90-102. [Free Full Text]
Cooper-Patrick L, Gallo JJ, Gonzales JJ, et al. Race, gender, and partnership in the patient-physician relationship. JAMA 1999;282:583-589. [Free Full Text]
Xu G, Fields SK, Laine C, Veloski JJ, Barzansky B, Martini CJ. The relationship between the race/ethnicity of generalist physicians and their care for underserved populations. Am J Public Health 1997;87:817-822. [Free Full Text]
Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient-physician racial concordance and the perceived quality and use of health care. Arch Intern Med 1999;159:997-1004. [Free Full Text]
Moy E, Bartman BA. Physician race and care of minority and medically indigent patients. JAMA 1995;273:1515-1520. [Free Full Text]
LaVeist TA, Carroll T. Race of physician and satisfaction with care among African-American patients. J Natl Med Assoc 2002;94:937-943. [Medline]
Pham, H. H., Landon, B. E., Reschovsky, J. D., Wu, B., Schrag, D.
(2009). Rapidity and Modality of Imaging for Acute Low Back Pain in Elderly Patients. Arch Intern Med
169: 972-981
[Abstract][Full Text]
Melsop, K., Brooks, M. M., Boothroyd, D. B., Hlatky, M. A.
(2009). Effect of Race on the Clinical Outcomes in the Bypass Angioplasty Revascularization Investigation Trial. Circ Cardiovasc Qual Outcomes
2: 186-190
[Abstract][Full Text]
McWilliams, J. M., Meara, E., Zaslavsky, A. M., Ayanian, J. Z.
(2009). Differences in Control of Cardiovascular Disease and Diabetes by Race, Ethnicity, and Education: U.S. Trends From 1999 to 2006 and Effects of Medicare Coverage. ANN INTERN MED
150: 505-515
[Abstract][Full Text]
Chin, M. H, Wilkes, A. E
(2009). Equity concerns in market-based control schemes for patient safety. Qual Saf Health Care
18: 88-90
[Full Text]
Spertus, J. A., Jones, P. G., Masoudi, F. A., Rumsfeld, J. S., Krumholz, H. M.
(2009). Factors Associated With Racial Differences in Myocardial Infarction Outcomes. ANN INTERN MED
150: 314-324
[Abstract][Full Text]
Atlas, S. J., Grant, R. W., Ferris, T. G., Chang, Y., Barry, M. J.
(2009). Patient-Physician Connectedness and Quality of Primary Care. ANN INTERN MED
150: 325-335
[Abstract][Full Text]
Sarrazin, M. V., Campbell, M., Rosenthal, G. E.
(2009). Racial Differences In Hospital Use After Acute Myocardial Infarction: Does Residential Segregation Play A Role?. Health Aff (Millwood)
28: w368-w378
[Abstract][Full Text]
Kleindorfer, D.
(2009). Sociodemographic Groups at Risk: Race/Ethnicity. Stroke
40: S75-S78
[Full Text]
Williams, D. R., Sternthal, M., Wright, R. J.
(2009). Social Determinants: Taking the Social Context of Asthma Seriously. Pediatrics
123: S174-S184
[Abstract][Full Text]
Pham, H. H., O'Malley, A. S., Bach, P. B., Saiontz-Martinez, C., Schrag, D.
(2009). Primary Care Physicians' Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination. ANN INTERN MED
150: 236-242
[Abstract][Full Text]
Varkey, A. B., Manwell, L. B., Williams, E. S., Ibrahim, S. A., Brown, R. L., Bobula, J. A., Horner-Ibler, B. A., Schwartz, M. D., Konrad, T. R., Wiltshire, J. C., Linzer, M., for the MEMO Investigators,
(2009). Separate and Unequal: Clinics Where Minority and Nonminority Patients Receive Primary Care. Arch Intern Med
169: 243-250
[Abstract][Full Text]
Farjah, F., Wood, D. E., Yanez, N. D. III, Vaughan, T. L., Symons, R. G., Krishnadasan, B., Flum, D. R.
(2009). Racial Disparities Among Patients With Lung Cancer Who Were Recommended Operative Therapy. Arch Surg
144: 14-18
[Abstract][Full Text]
Virnig, B. A., Baxter, N. N., Habermann, E. B., Feldman, R. D., Bradley, C. J.
(2009). A Matter Of Race: Early-Versus Late-Stage Cancer Diagnosis. Health Aff (Millwood)
28: 160-168
[Abstract][Full Text]
Bickell, N. A., Shastri, K., Fei, K., Oluwole, S., Godfrey, H., Hiotis, K., Srinivasan, A., Guth, A. A.
(2008). A Tracking and Feedback Registry to Reduce Racial Disparities in Breast Cancer Care. JNCI J Natl Cancer Inst
100: 1717-1723
[Abstract][Full Text]
Gerend, M. A., Pai, M.
(2008). Social Determinants of Black-White Disparities in Breast Cancer Mortality: A Review. Cancer Epidemiol. Biomarkers Prev.
17: 2913-2923
[Abstract][Full Text]
Gonzalez, H. M., Croghan, T., West, B., Williams, D., Nesse, R., Tarraf, W., Taylor, R., Hinton, L., Neighbors, H., Jackson, J.
(2008). Antidepressant Use in Black and White Populations in the United States. Psychiatr. Serv.
59: 1131-1138
[Abstract][Full Text]
Smith, D. B., Feng, Z., Fennell, M. L., Zinn, J., Mor, V.
(2008). Racial Disparities in Access to Long-Term Care: The Illusive Pursuit of Equity. Journal of Health Politics, Policy and Law
33: 861-881
[Abstract]
Bowen, M. E., Gonzalez, H. M.
(2008). Racial/Ethnic Differences in the Relationship Between the Use of Health Care Services and Functional Disability: The Health and Retirement Study (1992-2004). Gerontologist
48: 659-667
[Abstract][Full Text]
Basu, J., Mobley, L. R.
(2008). Trends in Racial Disparities Among the Elderly for Selected Procedures. Med Care Res Rev
65: 617-637
[Abstract]
Fiscella, K., Epstein, R. M.
(2008). So Much to Do, So Little Time: Care for the Socially Disadvantaged and the 15-Minute Visit. Arch Intern Med
168: 1843-1852
[Abstract][Full Text]
Lathan, C. S., Neville, B. A., Earle, C. C.
(2008). Racial Composition of Hospitals: Effects on Surgery for Early-Stage Non-Small-Cell Lung Cancer. JCO
26: 4347-4352
[Abstract][Full Text]
King, W D, Minor, P, Ramirez Kitchen, C, Ore, L E, Shoptaw, S, Victorianne, G D, Rust, G
(2008). Racial, gender and geographic disparities of antiretroviral treatment among US Medicaid enrolees in 1998. J. Epidemiol. Community Health
62: 798-803
[Abstract][Full Text]
Rooks, R. N., Simonsick, E. M., Klesges, L. M., Newman, A. B., Ayonayon, H. N., Harris, T. B.
(2008). Racial Disparities in Health Care Access and Cardiovascular Disease Indicators in Black and White Older Adults in the Health ABC Study. J Aging Health
20: 599-614
[Abstract]
Smith, A. K., Ladner, D., McCarthy, E. P.
(2008). Racial/Ethnic Disparities in Liver Transplant Surgery and Hospice Use: Parallels, Differences, and Unanswered Questions. AM J HOSP PALLIAT CARE
25: 285-291
[Abstract]
Baker, R. B., Washington, H. A., Olakanmi, O., Savitt, T. L., Jacobs, E. A., Hoover, E., Wynia, M. K.
(2008). African American Physicians and Organized Medicine, 1846-1968: Origins of a Racial Divide. JAMA
300: 306-313
[Abstract][Full Text]
Rhee, M. K., Ziemer, D. C., Caudle, J., Kolm, P., Phillips, L. S.
(2008). Use of a Uniform Treatment Algorithm Abolishes Racial Disparities in Glycemic Control. The Diabetes Educator
34: 655-663
[Abstract][Full Text]
Powe, N. R.
(2008). Let's Get Serious About Racial and Ethnic Disparities. J. Am. Soc. Nephrol.
19: 1271-1275
[Abstract][Full Text]
Wesson, D. E.
(2008). Is the Ethnic Disparity in CKD a Symptom of Dysfunctional Primary Care in the US?. J. Am. Soc. Nephrol.
19: 1249-1251
[Full Text]
Campbell, R. J.
(2008). Meeting Seniors' Information Needs: Using Computer Technology. Home Health Care Management Practice
20: 328-335
[Abstract]
Morris, A. M., Billingsley, K. G., Hayanga, A. J., Matthews, B., Baldwin, L.-M., Birkmeyer, J. D.
(2008). Residual Treatment Disparities After Oncology Referral for Rectal Cancer. JNCI J Natl Cancer Inst
100: 738-744
[Abstract][Full Text]
Adams, A. S., Trinacty, C. M., Zhang, F., Kleinman, K., Grant, R. W., Meigs, J. B., Soumerai, S. B., Ross-Degnan, D.
(2008). Medication Adherence and Racial Differences in A1C Control. Diabetes Care
31: 916-921
[Abstract][Full Text]
Reschovsky, J. D., O'Malley, A. S.
(2008). Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care?. Health Aff (Millwood)
27: w222-w231
[Abstract][Full Text]
Schackman, B. R., Teixeira, P. A., Weitzman, G., Mushlin, A. I., Jacobson, I. M.
(2008). Quality-of-Life Tradeoffs for Hepatitis C Treatment: Do Patients and Providers Agree?. Med Decis Making
28: 233-242
[Abstract]
Lurie, N., Somers, S. A., Fremont, A., Angeles, J., Murphy, E. K., Hamblin, A.
(2008). Challenges To Using A Business Case For Addressing Health Disparities. Health Aff (Millwood)
27: 334-338
[Abstract][Full Text]
Gaskin, D. J., Spencer, C. S., Richard, P., Anderson, G. F., Powe, N. R., LaVeist, T. A.
(2008). Do Hospitals Provide Lower-Quality Care To Minorities Than To Whites?. Health Aff (Millwood)
27: 518-527
[Abstract][Full Text]
Jha, A. K., Orav, E. J., Zheng, J., Epstein, A. M.
(2008). The Characteristics And Performance Of Hospitals That Care For Elderly Hispanic Americans. Health Aff (Millwood)
27: 528-537
[Abstract][Full Text]
Pani, L. N., Nathan, D. M., Grant, R. W.
(2008). Clinical Predictors of Disease Progression and Medication Initiation in Untreated Patients With Type 2 Diabetes and A1C Less Than 7%. Diabetes Care
31: 386-390
[Abstract][Full Text]
Howell, E. A., Hebert, P., Chatterjee, S., Kleinman, L. C., Chassin, M. R.
(2008). Black/White Differences in Very Low Birth Weight Neonatal Mortality Rates Among New York City Hospitals. Pediatrics
121: e407-e415
[Abstract][Full Text]
Blustein, J.
(2008). Who Is Accountable for Racial Equity in Health Care?. JAMA
299: 814-816
[Full Text]
Brown, D. R., Hernandez, A., Saint-Jean, G., Evans, S., Tafari, I., Brewster, L. G., Celestin, M. J., Gomez-Estefan, C., Regalado, F., Akal, S., Nierenberg, B., Kauschinger, E. D., Schwartz, R., Page, J. B.
(2008). A Participatory Action Research Pilot Study of Urban Health Disparities Using Rapid Assessment Response and Evaluation. Am. J. Public Health
98: 28-38
[Abstract][Full Text]
Saha, S., Shipman, S. A.
(2008). Race-Neutral Versus Race-Conscious Workforce Policy To Improve Access To Care. Health Aff (Millwood)
27: 234-245
[Abstract][Full Text]
Smith, W. R., Betancourt, J. R., Wynia, M. K., Bussey-Jones, J., Stone, V. E., Phillips, C. O., Fernandez, A., Jacobs, E., Bowles, J.
(2007). Recommendations for Teaching about Racial and Ethnic Disparities in Health and Health Care. ANN INTERN MED
147: 654-665
[Abstract][Full Text]
Ferrer, R. L.
(2007). Pursuing Equity: Contact With Primary Care and Specialist Clinicians by Demographics, Insurance, and Health Status. Ann Fam Med
5: 492-502
[Abstract][Full Text]
Landon, B. E., Schneider, E. C., Normand, S.-L. T., Scholle, S. H., Pawlson, L. G., Epstein, A. M.
(2007). Quality of Care in Medicaid Managed Care and Commercial Health Plans. JAMA
298: 1674-1681
[Abstract][Full Text]
Curtis, L. H., Al-Khatib, S. M., Shea, A. M., Hammill, B. G., Hernandez, A. F., Schulman, K. A.
(2007). Sex Differences in the Use of Implantable Cardioverter-Defibrillators for Primary and Secondary Prevention of Sudden Cardiac Death. JAMA
298: 1517-1524
[Abstract][Full Text]
Davis, A. M., Vinci, L. M., Okwuosa, T. M., Chase, A. R., Huang, E. S.
(2007). Cardiovascular Health Disparities: A Systematic Review of Health Care Interventions. Med Care Res Rev
64: 29S-100S
[Abstract]
Peek, M. E., Cargill, A., Huang, E. S.
(2007). Diabetes Health Disparities: A Systematic Review of Health Care Interventions. Med Care Res Rev
64: 101S-156S
[Abstract]
Chien, A. T., Chin, M. H., Davis, A. M., Casalino, L. P.
(2007). Pay for Performance, Public Reporting, and Racial Disparities in Health Care: How Are Programs Being Designed?. Med Care Res Rev
64: 283S-304S
[Abstract]
Heisler, M., Faul, J. D., Hayward, R. A., Langa, K. M., Blaum, C., Weir, D.
(2007). Mechanisms for Racial and Ethnic Disparities in Glycemic Control in Middle-aged and Older Americans in the Health and Retirement Study. Arch Intern Med
167: 1853-1860
[Abstract][Full Text]
Bloche, M. G.
(2007). Consumer-Directed Health Care And The Disadvantaged. Health Aff (Millwood)
26: 1315-1327
[Abstract][Full Text]
Smith, D. B., Feng, Z., Fennell, M. L., Zinn, J. S., Mor, V.
(2007). Separate And Unequal: Racial Segregation And Disparities In Quality Across U.S. Nursing Homes. Health Aff (Millwood)
26: 1448-1458
[Abstract][Full Text]
Berndt, S. I., Carter, H. B., Schoenberg, M. P., Newschaffer, C. J.
(2007). Disparities in Treatment and Outcome for Renal Cell Cancer Among Older Black and White Patients. JCO
25: 3589-3595
[Abstract][Full Text]
Bailey, J. E., Sprabery, L. R.
(2007). Inequitable Funding May Cause Health Care Disparities. Arch Intern Med
167: 1226-1228
[Full Text]
Hasnain-Wynia, R., Baker, D. W., Nerenz, D., Feinglass, J., Beal, A. C., Landrum, M. B., Behal, R., Weissman, J. S.
(2007). Disparities in Health Care Are Driven by Where Minority Patients Seek Care: Examination of the Hospital Quality Alliance Measures. Arch Intern Med
167: 1233-1239
[Abstract][Full Text]
Bickell, N. A., LePar, F., Wang, J. J., Leventhal, H.
(2007). Lost Opportunities: Physicians' Reasons and Disparities in Breast Cancer Treatment. JCO
25: 2516-2521
[Abstract][Full Text]
Jha, A. K., Orav, E. J., Li, Z., Epstein, A. M.
(2007). Concentration and Quality of Hospitals That Care for Elderly Black Patients. Arch Intern Med
167: 1177-1182
[Abstract][Full Text]
Casalino, L. P., Elster, A., Eisenberg, A., Lewis, E., Montgomery, J., Ramos, D.
(2007). Will Pay-For-Performance And Quality Reporting Affect Health Care Disparities?. Health Aff (Millwood)
26: w405-w414
[Abstract][Full Text]
Rodriguez, R. A., Sen, S., Mehta, K., Moody-Ayers, S., Bacchetti, P., O'Hare, A. M.
(2007). Geography Matters: Relationships among Urban Residential Segregation, Dialysis Facilities, and Patient Outcomes. ANN INTERN MED
146: 493-501
[Abstract][Full Text]
Crew, K. D., Neugut, A. I., Wang, X., Jacobson, J. S., Grann, V. R., Raptis, G., Hershman, D. L.
(2007). Racial Disparities in Treatment and Survival of Male Breast Cancer. JCO
25: 1089-1098
[Abstract][Full Text]
Pham, H. H., Schrag, D., O'Malley, A. S., Wu, B., Bach, P. B.
(2007). Care Patterns in Medicare and Their Implications for Pay for Performance. NEJM
356: 1130-1139
[Abstract][Full Text]
Lurie, N., Dubowitz, T.
(2007). Health Disparities and Access to Health. JAMA
297: 1118-1121
[Full Text]
Rust, G., Cooper, L. A.
(2007). How Can Practice-based Research Contribute to the Elimination of Health Disparities?. J Am Board Fam Med
20: 105-114
[Abstract][Full Text]
Sequist, T. D., Cullen, T., Hays, H., Taualii, M. M., Simon, S. R., Bates, D. W.
(2007). Implementation and Use of an Electronic Health Record within the Indian Health Service. J. Am. Med. Inform. Assoc.
14: 191-197
[Abstract][Full Text]
Losina, E., Wright, E. A., Kessler, C. L., Barrett, J. A., Fossel, A. H., Creel, A. H., Mahomed, N. N., Baron, J. A., Katz, J. N.
(2007). Neighborhoods Matter: Use of Hospitals With Worse Outcomes Following Total Knee Replacement by Patients From Vulnerable Populations. Arch Intern Med
167: 182-186
[Abstract][Full Text]
Hambidge, S. J., Emsermann, C. B., Federico, S., Steiner, J. F.
(2007). Disparities in Pediatric Preventive Care in the United States, 1993-2002. Arch Pediatr Adolesc Med
161: 30-36
[Abstract][Full Text]
Zapka, J. G., Carter, R., Carter, C. L., Hennessy, W., Kurent, J. E., DesHarnais, S.
(2006). Care at the End of Life: Focus on Communication and Race. J Aging Health
18: 791-813
[Abstract]
Sassi, F., Luft, H. S., Guadagnoli, E.
(2006). Reducing Racial/Ethnic Disparities in Female Breast Cancer: Screening Rates and Stage at Diagnosis. Am. J. Public Health
96: 2165-2172
[Abstract][Full Text]
Gorin, S. S., Heck, J. E., Cheng, B., Smith, S. J.
(2006). Delays in breast cancer diagnosis and treatment by racial/ethnic group.. Arch Intern Med
166: 2244-2252
[Abstract][Full Text]
Ferraro, K. F., Thorpe, R. J. Jr, McCabe, G. P., Kelley-Moore, J. A., Jiang, Z.
(2006). The color of hospitalization over the adult life course: cumulative disadvantage in black and white?. Journals of Gerontology Series B: Psychological Sciences and Social Science
61: S299-S306
[Abstract][Full Text]
Liu, J. H., Zingmond, D. S., McGory, M. L., SooHoo, N. F., Ettner, S. L., Brook, R. H., Ko, C. Y.
(2006). Disparities in the utilization of high-volume hospitals for complex surgery.. JAMA
296: 1973-1980
[Abstract][Full Text]
Winker, M. A.
(2006). Race and Ethnicity in Medical Research: Requirements Meet Reality. J Law Med Ethics
34: 520-525
Schnittker, J., Liang, K.
(2006). The promise and limits of racial/ethnic concordance in physician-patient interaction.. Journal of Health Politics, Policy and Law
31: 811-838
[Abstract]
Sirovich, B. E., Gottlieb, D. J., Welch, H. G., Fisher, E. S.
(2006). Regional Variations in Health Care Intensity and Physician Perceptions of Quality of Care. ANN INTERN MED
144: 641-649
[Abstract][Full Text]
Lemon, S. C., Zapka, J. G., Estabrook, B., Benjamin, E.
(2006). Challenges to Research in Urban Community Health Centers. Am. J. Public Health
96: 626-628
[Abstract][Full Text]
McGinnis, S., Moore, J., Continelli, T.
(2006). Practice patterns of underrepresented minority nurse practitioners in new york state, 2000.. Policy Politics Nursing Practice
7: 35-44
[Abstract]
Lathan, C. S., Neville, B. A., Earle, C. C.
(2006). The Effect of Race on Invasive Staging and Surgery in Non-Small-Cell Lung Cancer. JCO
24: 413-418
[Abstract][Full Text]
Trivedi, A. N., Sequist, T. D., Ayanian, J. Z.
(2006). Impact of Hospital Volume on Racial Disparities in Cardiovascular Procedure Mortality. J Am Coll Cardiol
47: 417-424
[Abstract][Full Text]
Adams, A. S., Zhang, F., Mah, C., Grant, R. W., Kleinman, K., Meigs, J. B., Ross-Degnan, D.
(2005). Race Differences in Long-Term Diabetes Management in an HMO. Diabetes Care
28: 2844-2849
[Abstract][Full Text]
Konrad, T. R., Howard, D. L., Edwards, L. J., Ivanova, A., Carey, T. S.
(2005). Physician-Patient Racial Concordance, Continuity of Care, and Patterns of Care for Hypertension. Am. J. Public Health
95: 2186-2190
[Abstract][Full Text]
Walker, A. R P, Walker, B. F
(2005). Socio-economic status: an insufficiently appreciated component of US health. The Journal of the Royal Society for the Promotion of Health
125: 254-254
Kressin, N. R.
(2005). Separate but Not Equal: The Consequences of Segregated Health Care. Circulation
112: 2582-2584
[Full Text]
Skinner, J., Chandra, A., Staiger, D., Lee, J., McClellan, M.
(2005). Mortality After Acute Myocardial Infarction in Hospitals That Disproportionately Treat Black Patients. Circulation
112: 2634-2641
[Abstract][Full Text]
McCullough, M. L., Feigelson, H. S., Diver, W. R., Patel, A. V., Thun, M. J., Calle, E. E.
(2005). Risk Factors for Fatal Breast Cancer in African-American Women and White Women in a Large US Prospective Cohort. Am J Epidemiol
162: 734-742
[Abstract][Full Text]
Schelbert, E. B., Rosenthal, G. E., Welke, K. F., Vaughan-Sarrazin, M. S.
(2005). Treatment Variation in Older Black and White Patients Undergoing Aortic Valve Replacement. Circulation
112: 2347-2353
[Abstract][Full Text]
Krumholz, H. M.
(2005). The Year in Epidemiology, Health Services, and Outcomes Research. J Am Coll Cardiol
46: 1362-1370
[Full Text]
Hershman, D., McBride, R., Jacobson, J. S., Lamerato, L., Roberts, K., Grann, V. R., Neugut, A. I.
(2005). Racial Disparities in Treatment and Survival Among Women With Early-Stage Breast Cancer. JCO
23: 6639-6646
[Abstract][Full Text]
Lu, P.-J., Singleton, J. A., Rangel, M. C., Wortley, P. M., Bridges, C. B.
(2005). Influenza Vaccination Trends Among Adults 65 Years or Older in the United States, 1989-2002. Arch Intern Med
165: 1849-1856
[Abstract][Full Text]
Lanting, L. C., Joung, I. M.A., Mackenbach, J. P., Lamberts, S. W.J., Bootsma, A. H.
(2005). Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients: A review. Diabetes Care
28: 2280-2288
[Abstract][Full Text]
Vaccarino, V., Rathore, S. S., Wenger, N. K., Frederick, P. D., Abramson, J. L., Barron, H. V., Manhapra, A., Mallik, S., Krumholz, H. M., the National Registry of Myocardial Infarction Inv,
(2005). Sex and Racial Differences in the Management of Acute Myocardial Infarction, 1994 through 2002. NEJM
353: 671-682
[Abstract][Full Text]
Trivedi, A. N., Zaslavsky, A. M., Schneider, E. C., Ayanian, J. Z.
(2005). Trends in the Quality of Care and Racial Disparities in Medicare Managed Care. NEJM
353: 692-700
[Abstract][Full Text]
Baldwin, L.-M., Dobie, S. A., Billingsley, K., Cai, Y., Wright, G. E., Dominitz, J. A., Barlow, W., Warren, J. L., Taplin, S. H.
(2005). Explaining Black-White Differences in Receipt of Recommended Colon Cancer Treatment. JNCI J Natl Cancer Inst
97: 1211-1220
[Abstract][Full Text]
Thomas, A. J., Eberly, L. E., Davey Smith, G., Neaton, J. D., Stamler, J., for the Multiple Risk Factor Intervention Trial Re,
(2005). Race/Ethnicity, Income, Major Risk Factors, and Cardiovascular Disease Mortality. Am. J. Public Health
95: 1417-1423
[Abstract][Full Text]
Pham, H. H., Schrag, D., Hargraves, J. L., Bach, P. B.
(2005). Delivery of Preventive Services to Older Adults by Primary Care Physicians. JAMA
294: 473-481
[Abstract][Full Text]
Previous
