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José J. Escarce, MD, PhD and Thomas G. McGuire, PhD

José J. Escarce is with RAND Health, Santa Monica, Calif, and the School of Public Health, University of California, Los Angeles. Thomas G. McGuire is with the Department of Health Care Policy, Harvard Medical School, Boston, Mass.

Correspondence: Requests for reprints should be sent to T. G. McGuire, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02115 (e-mail: mcguire{at}hcp.med.harvard.edu).

Objectives. We used 1997 Medicare data to replicate an earlier study that used data from 1986 to examine racial differences in usage of specific medical procedures or tests among elderly persons.

Methods. We used 1997 physician claims data to obtain a random sample of 5% of Medicare beneficiaries aged 65 years and older. We used this sample to study 30 procedures and tests that were analyzed in the 1986 study, as well as several new procedures that became more widely used in the early 1990s.

Results. Racial differences remain in the rates of use of these procedures; in general, Blacks have lower rates of use than do Whites. Between 1986 and 1997, the ratio of White to Black use moved in favor of Blacks for all but 4 of the established procedures studied.

Conclusions. The White–Black gap in health care use under Medicare is narrowing.

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