Urban Institute

About: Urban Institute is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Medicaid & Population. The organization has 927 authors who have published 2330 publications receiving 86426 citations.

Race and ethnic disparities in health care access and utilization: an examination of state variation.

Abstract: Health disparities among racial and ethnic groups have a long history and continue to exist in the United States. The U.S. government has established as a goal for the year 2010 the elimination of racial/ethnic health differences in six areas. This article examines disparities in one of those areas: access to high-quality health care. Several measures of access to and use of health care services are studied both nationally and in 13 diverse states. The authors find that both the magnitude of racial and ethnic disparity and the reasons behind it depend significantly on the state, the ethnic group, and the type of outcome measure being studied. Such information can be valuable for state and national policy makers in targeting resources and in designing effective strategies for the elimination of racial and ethnic disparities.

Variations in breast carcinoma treatment in older Medicare beneficiaries: Is it black and white?

Abstract: BACKGROUND To evaluate associations between race and breast carcinoma treatment. METHODS Data from 984 black and 849 white Medicare beneficiaries 67 years or older with local breast carcinoma and a subset of 732 surviving women interviewed 3–4 years posttreatment were used to calculate adjusted odds of treatment, controlling for age, comorbidity, attitudes, region, and area measures of socioeconomic and health care resources. RESULTS Sixty-seven percent of women received a mastectomy and 33% received breast-conserving surgery. The odds of radiation omission were 48% higher (95% confidence interval [CI] 1.01–2.19) for blacks than for whites after considering covariates, but the absolute number of women who failed to receive this modality was small (11%). In race-stratified models, the odds of having radiation omitted were significantly higher among blacks living greater distances from a cancer center (vs. lesser) or living in areas with high poverty (vs. low), but these factors did not affect radiation use among whites. Among those interviewed, blacks reported perceiving more ageism and racism in the health care system than whites (P = 0.001). The independent odds of receiving mastectomy (vs. breast conservation and radiation) were 2.72 times higher (95% CI 1.25–5.92) among women reporting the highest quartile of perceived ageism scores, compared with the lowest, and higher perceived ageism tended to be associated with higher odds of radiation omission (P = 0.06). CONCLUSIONS Older black women with localized breast carcinoma may have a different experience obtaining treatment than their white counterparts. The absolute number of women receiving nonstandard care was small and the effects were small to moderate. However, if these patterns persist, it will be important to evaluate whether such experiences contribute to within-stage race mortality disparities. Cancer 2002;95:1401–14. © 2002 American Cancer Society. DOI 10.1002/cncr.10825

Nonprofit Commercial Revenue: A Replacement for Declining Government Grants and Private Contributions?

Abstract: This article examines whether there has been an increase in nonprofit commercial revenue and if so whether declines in government grants and private contributions were behind the rise. A number of ...

Into the Eye of the Storm: Assessing the Evidence on Science and Engineering Education, Quality, and Workforce Demand

Abstract: Recent policy reports claim the United States is falling behind other nations in science and math education and graduating insufficient numbers of scientists and engineers. Review of the evidence and analysis of actual graduation rates and workforce needs does not find support for these claims. U.S. student performance rankings are comparable to other leading nations and colleges graduate far more scientists and engineers than are hired each year. Instead, the evidence suggests targeted education improvements are needed for the lowest performers and demand-side factors may be insufficient to attract qualified college graduates.