DISPARITIES IN CARE

Disparities in care among black and white Medicare enrollees

Concept Paper

Table of content

Introduction3

Statement of the Problem3

Purpose of the Study5

Brief Review of the Literature5

Research Method7

Strengths of Method and Design8

References9

Annotated bibliography11

Disparities in care among black and white Medicare enrollees

Introduction

As part of conducting a research study, whether quantitative, qualitative or mixed-method, one must develop a research method and design. The study method and design should be described in sufficient detail that the study can be replicated or duplicated. This paper will develop an envisioned methodology and design for my dissertation research topic, which is to explore underlying disparities in care among black and white Medicare enrollees. This methodology and design will be based on the research problem and questions. I will identify the strengths and weaknesses of the envisioned method and design, and provide a justification as to why this chosen method and design are most appropriate for the research questions. Lastly, I will provide an explanation of why alternative methods/designs would be less desirable for my understanding.

Statement of the Problem

A central problem besetting Medicare has been disparities in care among black and white enrollees (Zuckerman, 2008). Disparities exist in many needed services, including such preventive services as immunizations, routine physical examinations, and screening for cancer and other diseases. Black Americans are less likely than white Americans to receive many of the above vital health services. Disparities have also been found in areas of cardiac and diagnostic procedures, resulting in black patients being less likely to receive such treatments such as bypass grafting and renal transplantation. Researchers have uncovered several similar disparities through continuing and ongoing research in this vital public program(Musa, Schulz, Harris, Silverman & Thomas, 2009).

Organizations such as the Agency for Healthcare Research and Quality, the Institute of Medicine (IOM), the Disparities Solutions Centre and the Council on Ethical and Judicial Affairs of the American Medical Association have all investigated and researched disparities in care among black and white persons enrolled in Medicare, and have provided insight into why this problem exists. Yet a difficulty lies in the fact that even though researchers have been investigating this problem for years, disparities in care persist, with significant impacts on black persons who utilize Medicare in terms of wide gaps in care received (Klonoff, 2009).

According to Fongwa et al. (2008), disparities in healthcare have been consistently documented between blacks and whites, even among people with similar health care coverage. Klonoff (2009) showed that disparities have been observed for various kinds of diseases and treatments, including dementia, neck and head cancer, depression, cardiovascular disease, colorectal cancer testing and more.

Although a number of factors could figure in to any conceptual basis of the problem, researchers have sought to discern the most important causes. The principal ones cited have been differences in socioeconomic status between blacks and whites and discrepancies in claims submission (Fenton, Tancredi, Green, Franks, & Baldwin, 2009; Du & Liu, 2010; Fongwa et al., 2008). Other factors cited are a lack of participation from communities and families in research on ...