Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.33
Copyright © 2004 by Project HOPE

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Who You Are And Where You Live: How Race And Geography Affect The Treatment Of Medicare Beneficiaries

¹ Katherine Baicker is an assistant professor of economics at Dartmouth College (Hanover, New Hampshire); senior research associate, Center for the Evaluative Clinical Sciences, Dartmouth Medical School; and faculty research fellow at the National Bureau of Economic Research (NBER).
² Amitabh Chandra is an assistant professor of economics at Dartmouth College (Hanover, New Hampshire); senior research associate, Center for the Evaluative Clinical Sciences, Dartmouth Medical School; and faculty research fellow at the National Bureau of Economic Research (NBER).
³ Jonathan Skinner is the John French Professor of Economics at Dartmouth; a senior research associate at the center; a professor in the Department of Family and Community Medicine, Dartmouth Medical School; and a research associate at NBER.
⁴ John Wennberg directs the center; he is the Peggy Y. Thomson Professor for Evaluative Clinical Sciences, Dartmouth Medical School.

^*Corresponding author.

Abstract

The existence of overall racial and ethnic disparities in health care is well documented, but this average effect masks variation across regions and types of care. Medicare claims data are used to document the extent of these variations. Regions with high racial disparities in one procedure are not more likely to be high in other procedures. Unusually large racial disparities in surgery are often the result of high white rates rather than low black rates. Differences in end-of-life care are driven more by residence than by race. Policies should focus on getting the rates right, rather than solely on racial differences.

Key Words: Access To Care, Elderly, Hospitals, Medicare, Minority Health, Quality Of Care, Variations

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