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December 2004, Vol 94, No. 12 | American Journal of Public Health 2076-2078
© 2004 American Public Health Association

RESEARCH AND PRACTICE

Accounting for Apparent "Reverse" Racial Disparities in Department of Veterans Affairs (VA)–Based Medical Care: Influence of Out-of-VA Care

Andrea D. Gurmankin, PhD, MBe, Daniel Polsky, PhD and Kevin G. Volpp, MD, PhD

At the time of the study Andrea D. Gurmankin was with the Philadelphia/Pittsburgh VA Center for Health Equity Research and Promotion and the University of Pennsylvania Department of Psychology and Department of Medical Ethics. Daniel Polsky is with the Division of General Internal Medicine and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Kevin G. Volpp is with the Philadelphia VA Center for Health Equity Research and Promotion, the University of Pennsylvania School of Medicine, and the Wharton School.

Correspondence: Requests for reprints should be sent to Andrea D. Gurmankin, PhD, MBe, Dana-Farber Cancer Institute, 44 Binney St, SM 253, Boston, MA 02115 (e-mail: adg11{at}cornell.edu).

Conclusions regarding racial differences in care following a newly elevated prostate-specific antigen (PSA) test at the Department of Veterans Affairs (VA) may differ depending on whether follow-up care outside the VA is considered. Consecutive Philadelphia, Pa, VA patients with newly elevated PSA tests (n = 183) were interviewed 1 year after baseline. Among exclusive VA users, Blacks had higher rates of urology referrals and prostate biopsies compared with Whites. However, these racial differences were attenuated when care obtained outside the VA also was considered.




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[Abstract] [Full Text] [PDF]


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