National Healthcare Disparities Report - LDI Health Economist

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Efficiency Figure 7.8. Males age 75 and over who reported having a prostate-specific antigen test or a digital rectal exam within the last 12 months, by race and income, 2004-2010 100 White Black Asian AI/AN Other/Missing 100 Poor Low Income Middle Income High Income 75 75 Chapter 7 Percent 50 2008 Achievable Benchmark: 62% Percent 50 2008 Achievable Benchmark: 62% 25 Z 0 2004 2006 2008 2010 25 Z 0 2004 2006 2008 2010 Key: AI/AN = American Indian/Alaska Native. Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2004-2010. Denominator: Adult males age 75 and over with no history of prostate cancer. Note: For this measure, lower rates are better. Data for 2004, 2006, and part of 2008 precede the U.S. Preventive Services Task Force recommendation against screening men age 75 and over. It should be noted that PSA tests and DREs are provided to this population for purposes unrelated to prostate cancer screening. Data to determine the purpose of these services were unavailable and all reported PSA tests and DREs are reflected in the data shown. Data for AI/ANs were statistically unreliable for 2004 and 2006, as were data for Asians for 2004. n Between 2004 and 2010, the overall percentage of males age 75 and over who had a PSA test or a DRE within the last 12 months increased from 71% to 74% (data not shown). n In all years presented, the percentage of males age 75 and over who had a PSA test or a DRE within the last 12 months was lower for Blacks than for Whites (Figure 7.8). n In all years presented, the percentage of males age 75 and over who had a PSA test or a DRE within the last 12 months was lower for the lowest two income groups than for high-income males. n In 2008, the top 5 State benchmark for males age 75 and over who had a PSA or DRE exam was 62%. iv There was no evidence of overall movement toward the benchmark, and only poor males had attained the benchmark. iv The top 5 States that contributed to the achievable benchmark are California, Hawaii, Louisiana, New Jersey, and Tennessee. 200 National Healthcare Disparities Report, 2011
Efficiency References Fisher ES, Wennberg DE, Stukel TA, et al. The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med 2003 Feb 18;138(4):273-87. Lau DT, Kasper JD, Potter DE, et al. Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents. Arch Intern Med 2005 Jan 10;165(1):68-74. McGlynn E. Identifying, categorizing, and evaluating health care efficiency measures. Rockville, MD: Agency for Healthcare Research and Quality; 2008. AHRQ Publication No. 08-0030. Available at: http://www.ahrq.gov/qual/efficiency. Accessed December 8, 2009. Screening for prostate cancer. Rockville, MD: Agency for Healthcare Research and Quality; 2008. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsprca.htm. Accessed August 13, 2009. Zhan C, Sangl J, Bierman AS, et al. Potentially inappropriate medication use in the community-dwelling elderly: findings from the 1996 Medical Expenditure Panel Survey. JAMA 2001 Dec 12;286(22):2823-9. Chapter 7 National Healthcare Disparities Report, 2011 201
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