Disparities in preventive procedures: comparisons of self-report and Medicare claims data

BACKGROUND: Racial/ethnic disparities are assessed using either self-report or claims data. We compared these two data sources and examined contributors to discrepancies in estimates of disparities. METHODS: We analyzed self-report and matching claims data from Medicare Beneficiaries 65 and older who participated in the Medicare Current Beneficiary Survey, 1999–2002. Six preventive procedures were included: PSA testing, influenza vaccination, Pap smear testing, cholesterol testing, mammography, and colorectal cancer testing. We examined predictors of self-reports in the absence of claims and claims in the absence of self-reports. RESULTS: With the exception of PSA testing, racial/ethnic disparities in preventive procedures are generally larger when using Medicare claims than when using patients' self-report. Analyses adjusting for age, gender, income, educational level, health status, proxy response and supplemental insurance showed that minorities were more likely to self-report preventive procedures in the absence of claims. Adjusted odds ratios ranged from 1.07 (95% CI: 0.88 – 1.30) for PSA testing to 1.83 (95% CI: 1.46 – 2.30) for Pap smear testing. Rates of claims in the absence of self-report were low. Minorities were more likely to have PSA test claims in the absence of self-reports (1.55 95% CI: 1.17 – 2.06), but were less likely to have influenza vaccination claims in the absence of self-reports (0.69 95% CI: 0.51 – 0.93). CONCLUSION: These findings are consistent with either racial/ethnic reporting biases in receipt of preventive procedures or less efficient Medicare billing among providers with large minority practices

Higgs field in cosmology

The accelerated expansion of the early universe is an integral part of modern cosmology and dynamically realized by the mechanism of inflation. The simplest theoretical description of the inflationary paradigm is based on the assumption of an additional propagating scalar degree of freedom which drives inflation - the inflaton. In most models of inflation the fundamental nature of the inflaton remains unexplained. In the model of Higgs inflation, the inflaton is identified with the Standard Model Higgs boson and connects cosmology with elementary particle physics. A characteristic feature of this model is a non-minimal coupling of the Higgs boson to gravity. I review and discuss several phenomenological and fundamental aspects of this model, including the impact of quantum corrections and the renormalization group, the derivation of initial conditions for Higgs inflation in a quantum cosmological framework and the classical and quantum equivalence of different field parametrizations.Comment: 36 pages, 9 figures; references added, typos corrected. Invited contribution to the Heraeus-Seminar "Hundred Years of Gauge Theory", 30 July - 3 August 2018, Physikzentrum Bad Honnef, organized by Silvia De Bianchi and Claus Kiefer. To appear in the proceedings "100 Years of Gauge Theory. Past, present and future perspectives" in the series `Fundamental Theories of Physics' (Springer