Disparities in Primary Care by Race and Ethnicity among Medicaid Children in California

Arpita Chattopadhyay, University of California, San Francisco

Racial and ethnic disparities in primary care for children are well documented, but poorly understood. This study examines variation in preventable hospitalization rates of Medicaid children in California to extend our understanding of racial and ethnic disparity in primary care quality. I estimated a multivariate Poisson model from administrative data. The results show that primary care quality varies substantially by race and ethnicity even after controlling for beneficiaries’ primary language. The domain of primary care that minority children experience varies by race and ethnicity. Compared to white children, African-American children lack continuity and comprehensiveness of care necessary for the management of chronic conditions. Hispanic children, on the other hand have inadequate first contact care. Asian children experience a better quality of care overall. Independent of race, a non-English primary language has a protective effect on preventable hospitalization. The study finds no evidence of linguistic minorities’ disadvantage in managed care.