Disentangling the Complex Racial Disparities in Health among Adult Beneficiaries under Medicaid Managed Care: A Structural Equation Modeling Approach

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Sun, C. (2010). Disentangling the Complex Racial Disparities in Health among Adult Beneficiaries under Medicaid Managed Care: A Structural Equation Modeling Approach. Unc Charlotte Electronic Theses And Dissertations.
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Abstract

There are few studies of the important issue of racial and ethnic disparities in Medicaid managed care settings. This study addresses this deficiency using data collected by telephone interviews from a randomly stratified sample of adults who were continuously enrolled in North Carolina Medicaid managed care for at least six months prior to sampling in 2006. It uses univariate statistics to describe health status and conducts a Pearson chi-square test to examine health status between non-Hispanic black adults and non-Hispanic white adults. Because chronic conditions were significantly related to health status, the study also computes three separate structural equation models to investigate the complex relationships between race, health status, and a number of other independent variables that theory suggests. The Medicaid managed care adult population had bad health: 50.02% reported "poor" or "fair" health, and 63.60% suffered from a chronic condition. Yet, contrary to most of the literature on race and health, the health status of non-Hispanic black adults in this study was significantly superior to that reported by non-Hispanic white adults. This surprising finding held for both the model of overall sample of adults, which fitted adequately with the sample data (CFI=0.921; RMSEA=.035) and explained 31% of the variance in health, and the model of adults with chronic conditions, which also fitted adequately with the sample data (CFI=0.93; RMSEA=.036) and explained 22% of the variance in health.

Details
Author

Sun, Chengxiu

Title

Disentangling the Complex Racial Disparities in Health among Adult Beneficiaries under Medicaid Managed Care: A Structural Equation Modeling Approach

Physical Description

1 online resource (200 pages) : PDF

Date

2010

Degree Granting Institution

University of North Carolina at Charlotte

Abstract

There are few studies of the important issue of racial and ethnic disparities in Medicaid managed care settings. This study addresses this deficiency using data collected by telephone interviews from a randomly stratified sample of adults who were continuously enrolled in North Carolina Medicaid managed care for at least six months prior to sampling in 2006. It uses univariate statistics to describe health status and conducts a Pearson chi-square test to examine health status between non-Hispanic black adults and non-Hispanic white adults. Because chronic conditions were significantly related to health status, the study also computes three separate structural equation models to investigate the complex relationships between race, health status, and a number of other independent variables that theory suggests. The Medicaid managed care adult population had bad health: 50.02% reported "poor" or "fair" health, and 63.60% suffered from a chronic condition. Yet, contrary to most of the literature on race and health, the health status of non-Hispanic black adults in this study was significantly superior to that reported by non-Hispanic white adults. This surprising finding held for both the model of overall sample of adults, which fitted adequately with the sample data (CFI=0.921; RMSEA=.035) and explained 31% of the variance in health, and the model of adults with chronic conditions, which also fitted adequately with the sample data (CFI=0.93; RMSEA=.036) and explained 22% of the variance in health.

Genre

doctoral dissertations

Subjects--Topics

Government policy
Health services administration
Public health--Study and teaching

Degree

Ph.D.

Keywords

Adult
Managed Care
Medicaid
Racial Disparities in Health
Structural Equation Modeling

Subject Area

Public Policy

Advisor(s)

Brandon, William

Committee Members

Troyer, Jennifer
Warren-Findlow, Jan
Whitmeyer, Joseph
Walker, Lisa

Degree Note

Thesis (Ph.D.)--University of North Carolina at Charlotte, 2010.

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Rights Holder Information

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Identifier

Sun_uncc_0694D_10140

Permalink

http://hdl.handle.net/20.500.13093/etd:684