IDEAS home Printed from https://ideas.repec.org/a/kap/atlecj/v37y2009i3p299-314.html

Black-White Disparities in Care in Nursing Homes

Author

Listed:
  • David Grabowski

  • Thomas McGuire

Abstract

Nursing homes serve many severely ill poor people, including large numbers of racial/ethnic minority residents. Previous research indicates that blacks tend to receive care from lower quality nursing homes. Using the Institute of Medicine (IOM) definition of racial-ethnic disparities, this study decomposes nursing home disparities into within and across facility components. Using detailed person-level nursing home data, we find meaningful black-white disparities for one of the four risk-adjusted quality measures, with both within and across nursing home components of the disparity. The IOM approach, which recognizes mediation through payer status and education, has a small effect on measured disparities in this setting. Although we did not find disparities across the majority of quality measures and alternate disparity definitions, this approach can be applied to other health care services in an effort to disentangle the role of across and within facility variation and the role of potential mediators on racial/ethnic disparities. Copyright International Atlantic Economic Society 2009

Suggested Citation

  • David Grabowski & Thomas McGuire, 2009. "Black-White Disparities in Care in Nursing Homes," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 299-314, September.
    • Handle: RePEc:kap:atlecj:v:37:y:2009:i:3:p:299-314
    DOI: 10.1007/s11293-009-9185-7
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s11293-009-9185-7
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s11293-009-9185-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    2. Amitabh Chandra & Jonathan Skinner, 2003. "Geography and Racial Health Disparities," NBER Working Papers 9513, National Bureau of Economic Research, Inc.
    3. Howard, D.L. & Sloane, P.D. & Zimmerman, S. & Eckert, J.K. & Walsh, J.F. & Buie, V.C. & Taylor, P.J. & Koch, G.G., 2002. "Distribution of African Americans in residential care/assisted living and nursing homes: More evidence of racial disparity?," American Journal of Public Health, American Public Health Association, vol. 92(8), pages 1272-1277.
    4. Barry I. Graubard & Edward L. Korn, 1999. "Predictive Margins with Survey Data," Biometrics, The International Biometric Society, vol. 55(2), pages 652-659, June.
    5. Fairlie, Robert W., 2003. "An Extension of the Blinder-Oaxaca Decomposition Technique to Logit and Probit Models," Center Discussion Papers 28425, Yale University, Economic Growth Center.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bhaumik, Sumon Kumar & Gang, Ira N. & Yun, Myeong-Su, 2006. "Ethnic conflict and economic disparity: Serbians and Albanians in Kosovo," Journal of Comparative Economics, Elsevier, vol. 34(4), pages 754-773, December.
    2. Pylypchuk, Yuriy & Selden, Thomas M., 2008. "A discrete choice decomposition analysis of racial and ethnic differences in children's health insurance coverage," Journal of Health Economics, Elsevier, vol. 27(4), pages 1109-1128, July.
    3. Sumon Bhaumik & Ira Gang & Myeong-Su Yun, 2005. "Ethnic Conflict and Economic Disparity: Serbians & Albanians in Kosovo," William Davidson Institute Working Papers Series wp808, William Davidson Institute at the University of Michigan.
    4. Cho, Donghun, 2007. "The role of high school performance in explaining women's rising college enrollment," Economics of Education Review, Elsevier, vol. 26(4), pages 450-462, August.
    5. Karabchuk Tatiana, 2009. "Determinants of temporary employment for men and women in Russia," EERC Working Paper Series 09/11e, EERC Research Network, Russia and CIS.
    6. Gábor Kertesi & Gábor Kézdi, 2011. "Roma employment in Hungary after the post‐communist transition," The Economics of Transition, The European Bank for Reconstruction and Development, vol. 19(3), pages 563-610, July.
    7. Claus Schnabel & Joachim Wagner, 2007. "The Persistent Decline in Unionization in Western and Eastern Germany, 1980-2004 - What Can We Learn from a Decomposition Analysis?," Industrielle Beziehungen - Zeitschrift fuer Arbeit, Organisation und Management - The German Journal of Industrial Relations, Rainer Hampp Verlag, vol. 14(2), pages 118-132.
    8. Karolina Goraus & Joanna Tyrowicz, 2014. "Gender Wage Gap in Poland – Can It Be Explained by Differences in Observable Characteristics?," Ekonomia journal, Faculty of Economic Sciences, University of Warsaw, vol. 36.
    9. Dimara, Efthalia & Manganari, Emmanouela & Skuras, Dimitris, 2017. "Don't change my towels please: Factors influencing participation in towel reuse programs," Tourism Management, Elsevier, vol. 59(C), pages 425-437.
    10. Tamás Bartus, 2006. "Marginal effects and extending the Blinder–Oaxaca decomposition for nonlinear models," United Kingdom Stata Users' Group Meetings 2006 05, Stata Users Group.
    11. Mizunoya, Suguru & Mitra, Sophie, 2013. "Is There a Disability Gap in Employment Rates in Developing Countries?," World Development, Elsevier, vol. 42(C), pages 28-43.
    12. Govert E. Bijwaard & Justus Veenman, 2008. "Unequal Chances on a Flexible Labor Market, The Case of the Netherlands," Tinbergen Institute Discussion Papers 08-005/4, Tinbergen Institute.
    13. Schweri, Juerg & Mueller, Barbara, 2007. "Why has the share of training firms declined in Switzerland?," Zeitschrift für ArbeitsmarktForschung - Journal for Labour Market Research, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany], vol. 40(2/3), pages 149-167.
    14. Schweri, Juerg & Mueller, Barbara, 2007. "Why has the share of training firms declined in Switzerland?," Zeitschrift für ArbeitsmarktForschung - Journal for Labour Market Research, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany], vol. 40(2/3), pages 149-167.
    15. Arndt, Breanna J., "undated". "Explaining Income-Related Disparities in Pap Smear Utilization: A regression-based decomposition analysis of differences in Pap smear utilization following implementation of the Affordable Care Act," Master's Theses and Plan B Papers 265600, University of Minnesota, Department of Applied Economics.
    16. González Álvarez, M Luz & Barranquero, Antonio Clavero, 2009. "Inequalities in health care utilization in Spain due to double insurance coverage: An Oaxaca-Ransom decomposition," Social Science & Medicine, Elsevier, vol. 69(5), pages 793-801, September.
    17. Zhaoyi Cao & Tim Maloney, 2017. "Decomposing Ethnic Differences in University Academic Achievement in New Zealand," Working Papers 2017-02, Auckland University of Technology, Department of Economics.
    18. Joachim Wagner, 2007. "What a Difference a Y makes-Female and Male Nascent Entrepreneurs in Germany," Small Business Economics, Springer, vol. 28(1), pages 1-21, January.
    19. Tao Zhang & Jing Liu & Chaojie Liu, 2019. "Changes in Perceived Accessibility to Healthcare from the Elderly between 2005 and 2014 in China: An Oaxaca–Blinder Decomposition Analysis," IJERPH, MDPI, vol. 16(20), pages 1-12, October.
    20. Frenette, Marc, 2007. "Why Are Youth from Lower-income Families Less Likely to Attend University? Evidence from Academic Abilities, Parental Influences, and Financial Constraints," Analytical Studies Branch Research Paper Series 2007295e, Statistics Canada, Analytical Studies Branch.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:atlecj:v:37:y:2009:i:3:p:299-314. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.