| One of the most vexing policy issues in health care today is that of the continued presence of disparities. The current evidence on disparities in health care is ubiquitous and clearly race is a factor. Several measures of disparity, including mortality rates, quality of care and access to preventative, primary and follow up care demonstrate disparities among Blacks when compared to Whites. Much research has gone into examining the causes of health care disparities, but not a great deal examines the role of prevalence in those disparities.;This study seeks to examine the role of prevalence in health care disparities and posits that having a rare disease exposes one to greater disparities than non-rare disease. The 2006 HCUP Nationwide Inpatient Sample (NIS) was utilized, which captured patient and hospital-level data for all discharges from 658 participating hospitals in 29 states. Discharges for three rare cancers and three non-rare cancers were used (n = 10,548 and 41,323 respectively). Ordinary least squares (OLS) and logistic regression models were run with logged cost estimates (resources use measure) and the likelihood of dying in hospital (mortality measure) as dependent variables respectively.;No statistically significant difference could be found between rare and non-rare cancers in terms of the resource use and mortality measures. In terms of race (Black vs. White), no statistically significant difference was found in the rare cohorts for either outcome measure (resource use measure: p = .054; mortality measure: p = .885). The likelihood of dying for Black non-rare cancer sufferers (relative to Whites) was statistically significant at p < .05. Resource use and mortality were largely driven by disease severity and comorbidity measures. Blacks have more comorbidities on average than Whites. Finally, Medicare significantly increased costs and significantly decreased mortality in all cohorts while having an alternate source of insurance (ex. CHAMPUS, Worker's Compensation) significantly reduced costs for the non-rare cohort but increased their likelihood of dying in hospital. |
