Table 2.

Hazard Ratios (HR) for the primary independent variables for the outcomes of new dementia diagnosis

	2SRI						Logit
	Dementia
	First‐stage AWV utilization model			Second‐stage diagnosis model			Observational diagnosis model
	HR	95% CI	P	HR	95% CI	P	HR	95% CI	P
AWV utilization within 6 mo
White				2.34	2.13, 2.58	<.001	0.87	0.81, 0.94	<.001
Black				2.22	1.71, 2.89	<.001	0.81	0.63, 1.05	.11
Asian				4.82	2.94, 7.89	<.001	1.74	1.06, 2.83	.03
Hispanic				6.14	3.70, 10.19	<.001	2.19	1.32, 3.61	.002
Race‐Specific WMV utilization (exogenous identifying variables)
White	101.53	83.73, 123.12	<.001
Black	1.69	1.56, 1.84	<.001
Asian	1.43	1.31, 1.56	<.001
Hispanic	1.16	1.01, 1.33	.04
Residual				0.28	0.26, 0.30	<.001

Joint F‐test for all four instruments: F = 2435.58, P < .001. Estimates are adjusted for demographic and socioeconomic factors, health status, and healthcare utilization in the prior year (see Table S1 for all covariates). Stage 1 estimates indicate a strong relationship between county‐level Welcome to Medicare Visit Utilization and Annual Wellness Visit (AWV) Utilization for all racial groups. Observational estimates show a modest protective effect of AWV utilization on new dementia diagnosis for white and black beneficiaries, and a positive effect of AWV utilization on new dementia diagnosis for Hispanic and Asian beneficiaries. Second stage estimates show positive and higher (relative to observational estimates) effects of AWV utilization on new dementia diagnosis for all racial groups.