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The Effect Modification of Supplemental Insurance on the Relationship Between Race and Bone Mineral Density Screening in Female Medicare Beneficiaries
Authors:Ji Won Yoo  Shunichi Nakagawa  Sulgi Kim
Institution:1. Department of Internal Medicine, University of Michigan Medical School, 300 North Ingalls Building, Room 932, Ann Arbor, MI, 48109, USA
2. Geriatric Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
3. Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA
4. Geriatric Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
5. Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
Abstract:To determine the effect modification of supplemental insurance on the relationship between race and bone mineral density (BMD) in female Medicare beneficiaries. Retrospectively analyzing hospital administrative claim and clinical data of female Medicare beneficiaries (n?=?1,398), we performed multivariate logistic regressions of BMD testing including data from all study participants and the subsets of health insurance. Significantly fewer Black than White female Medicare beneficiaries received the BMD testing in the overall sample (odds ratio, OR?=?0.63; p?=?0.02) and those without supplementary health insurance (n?=?709; OR?=?0.38; p?=?0.004). By contrast, the magnitude of this racial disparity in the BMD testing was diminished among those with supplementary private health insurance (n?=?689). We found a significant racial disparity in BMD testing for Black and White female Medicare beneficiaries. This disparity became more pronounced among those without supplementary private health insurance.
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