FRIDAY, Oct. 27, 2023 (HealthDay News) — Older adult Black patients have higher adjusted receipt of nine low-value services, including acute diagnostic tests, and lower receipt of 20 services than White patients, according to a study published online Oct. 25 in The BMJ.
Ishani Ganguli, M.D., M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues characterized racial differences in receipt of low-value care among older Medicare beneficiaries in a retrospective cohort study involving 9,833,304 Black and White Medicare patients (6.8 percent Black) aged 65 years or older as of 2016. The main outcome measures were receipt of 40 low-value services.
The researchers found that compared with White patients, Black patients had higher adjusted receipt of nine services and lower receipt of 20 services. Black patients were more likely to receive low-value acute diagnostic tests, including imaging for uncomplicated headache and head computed tomography scans for dizziness (6.9 versus 3.2 percent and 3.1 versus 1.9 percent, respectively). Higher rates of low-value screening tests and treatments were seen for White patients, including preoperative laboratory tests (10.3 versus 6.5 percent), prostate-specific antigen (PSA) tests (31.0 versus 25.7 percent), and antibiotics for upper respiratory infections (36.6 versus 32.7 percent). These differences persisted within given health systems in secondary analyses and were not explained by receipt of care from different systems among Black and White patients.
“Even small differences might be clinically important because of the direct and indirect effects of low-value care, while the patterns across service categories suggest hypotheses about underlying mechanisms,” the authors write.
Several authors disclosed ties to industry.