The study population included all Medicare beneficiaries, 18 years and older, who received home health care in 2015 (4,243,090 people). Two data sources containing three race/ethnicity variables for our sample of Medicare beneficiaries were linked using the unique Chronic Conditions Warehouse (CCW) beneficiary identification number for the entire study population: The 2015 Medicare Beneficiary Summary File (MBSF) containing the Enrollment Database (EDB) race variable and Research Triangle Institute (RTI) race variable; and the 2015 Outcome and Assessment Information Set (OASIS) containing the ‘gold-standard’ self-reported race/ethnicity for all home health care patients. All three race variables (EDB, RTI, OASIS) were available for the entire study population.
During the initial home health care visit by a registered nurse or licensed physical therapist, as part of the standardized OASIS assessment, race/ethnicity data are obtained by self-report (a caregiver may answer if the patient is unable) and allows for multiple answers to be recorded. The directions for this question include the words “Mark all that apply” and the response choices are: 1) American Indian or Alaska Native, 2) Asian, 3) Black or African-American, 4) Hispanic or Laino, 5) Native Hawaiian or Pacific Islander, and 6) White.
For the purposes of this paper, and for consistency with the EDB and RTI race variable categories, beneficiaries who self-identified as eitheror both 1) Asian and 2) Native Hawaiian or Pacific Islander were classified as Asian American/Pacific Islander (AAPI). The vast majority (99.73%) of home health beneficiaries had only a single race/ethnicity recorded, and we restricted our study to this population. Details of the remaining 11,720 people (0.27% of study population) who identified with two or more racial/ethnic groups are included for the interested reader as a brief Appendix . Our final study sample consisted of 4,231,370 adult Medicare beneficiaries who received home health care in 2015. The study was approved by the Institutional Review Board of [replace with the authors’ academic institution].
During the initial home health care visit by a registered nurse or licensed physical therapist, as part of the standardized OASIS assessment, race/ethnicity data are obtained by self-report (a caregiver may answer if the patient is unable) and allows for multiple answers to be recorded. The directions for this question include the words “Mark all that apply” and the response choices are: 1) American Indian or Alaska Native, 2) Asian, 3) Black or African-American, 4) Hispanic or Laino, 5) Native Hawaiian or Pacific Islander, and 6) White.
For the purposes of this paper, and for consistency with the EDB and RTI race variable categories, beneficiaries who self-identified as either
