Epidemiology of medicare abuse : The example of power wheelchairs

摘要: OBJECTIVES: To determine the effect of neighborhood ethnic composition on power wheelchair prescriptions. DESIGN: The 5% noncancer sample Medicare recipients in Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, from 1994 to 2001. SETTING: SEER regions. PARTICIPANTS: Individuals covered by living regions without a cancer diagnosis. MEASUREMENTS: Individual characteristics (age, sex, ethnicity, justifying diagnosis, comorbidity), primary diagnoses, (percentage black, percentage Hispanic, with <12 years education, median income), region. RESULTS: rate prescriptions was 33 times greater 2001 than 1994, shift over time diagnoses more closely tied mobility impairment, such as strokes, less-specific medical osteoarthritis. In multilevel, multivariate analyses, individuals neighborhoods higher percentages blacks or Hispanics were likely receive wheelchairs (odds ratios=1.09 for each 10% increase black residents 1.23 Hispanic residents) after controlling ethnicity other at individual level. CONCLUSION: These results support allegations that marketers promoting have specifically targeted minority neighborhoods.