Is there equity in the home health care market? Understanding racial patterns in the use of formal home health care

Shelley White-Means, Rose M. Rubin

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective. This article explores whether the formal home health care (HHC) market is equitable or manifests unexplained racial disparities in use. Methods. The database is the 1994 National Long Term Care Survey. We estimate logit regression models with a race dummy variable, race interaction terms, and stratification by race. We apply the Oaxaca decomposition technique to quantify whether the observed racial gap in formal HHC use is explained by racial differences in predisposing, enabling, need, and environmental characteristics. Results. We find numerous unique racial patterns in HHC use. Blacks with diabetes and low income have higher probabilities of HHC use than their White counterparts. Black older persons have a 25% higher chance of using HHC than Whites. Our Oaxaca analysis indicates that racial differences in predisposing, enabling, need, and environmental characteristics account for the racial gap in use of HHC. Discussion. We find that the HHC market is equitable, enhancing availability, aceptability, and accessibility of care for older Black persons. Thus, the racial differences that we find are not racial disparities.

Original languageEnglish (US)
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume59
Issue number4
DOIs
StatePublished - Jan 1 2004

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Health Care Sector
Home Care Services
equity
health care
Delivery of Health Care
market
Long-Term Care
chronic illness
low income
Logistic Models
Databases
regression
human being
interaction

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies

Cite this

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abstract = "Objective. This article explores whether the formal home health care (HHC) market is equitable or manifests unexplained racial disparities in use. Methods. The database is the 1994 National Long Term Care Survey. We estimate logit regression models with a race dummy variable, race interaction terms, and stratification by race. We apply the Oaxaca decomposition technique to quantify whether the observed racial gap in formal HHC use is explained by racial differences in predisposing, enabling, need, and environmental characteristics. Results. We find numerous unique racial patterns in HHC use. Blacks with diabetes and low income have higher probabilities of HHC use than their White counterparts. Black older persons have a 25{\%} higher chance of using HHC than Whites. Our Oaxaca analysis indicates that racial differences in predisposing, enabling, need, and environmental characteristics account for the racial gap in use of HHC. Discussion. We find that the HHC market is equitable, enhancing availability, aceptability, and accessibility of care for older Black persons. Thus, the racial differences that we find are not racial disparities.",
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N2 - Objective. This article explores whether the formal home health care (HHC) market is equitable or manifests unexplained racial disparities in use. Methods. The database is the 1994 National Long Term Care Survey. We estimate logit regression models with a race dummy variable, race interaction terms, and stratification by race. We apply the Oaxaca decomposition technique to quantify whether the observed racial gap in formal HHC use is explained by racial differences in predisposing, enabling, need, and environmental characteristics. Results. We find numerous unique racial patterns in HHC use. Blacks with diabetes and low income have higher probabilities of HHC use than their White counterparts. Black older persons have a 25% higher chance of using HHC than Whites. Our Oaxaca analysis indicates that racial differences in predisposing, enabling, need, and environmental characteristics account for the racial gap in use of HHC. Discussion. We find that the HHC market is equitable, enhancing availability, aceptability, and accessibility of care for older Black persons. Thus, the racial differences that we find are not racial disparities.

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