Health Aff (Millwood). 2013 Jun;32(6):1046-53. doi: 10.1377/hlthaff.2011.1365.
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
SourceDivision of Minimally Invasive Surgery, University of Michigan, Ann Arbor, Michigan, USA. email@example.com
Research has shown that black patients more frequently undergo surgery at low-quality hospitals than do white patients. We assessed the extent to which living in racially segregated areas and living in geographic proximity to low-quality hospitals contribute to this disparity. Using national Medicare data for all patients who underwent one of three high-risk surgical procedures in 2005-08, we found that black patients actually tended to live closer to higher-quality hospitals than white patients did but were 25-58 percent more likely than whites to receive surgery at low-quality hospitals. Racial segregation was also a factor, with black patients in the most segregrated areas 41-96 percent more likely than white patients to undergo surgery at low-quality hospitals. To address these disparities, care navigators and public reporting of comparative quality could steer patients and their referring physicians to higher-quality hospitals, while quality improvement efforts could focus on improving outcomes for high-risk surgery at hospitals that disproportionately serve black patients. Unfortunately, existing policies such as pay-for-performance, bundled payments, and nonpayment for adverse events may divert resources and exacerbate these disparities.
KEYWORDS:Access To Care, Disparities, Minority Health, Quality Of Care
- Racial disparities in hospital selection. [Health Aff (Millwood). 2013]
- [PubMed - in process]