160675 Do minority patients use low quality hospitals?

Sunday, November 4, 2007

Darrell Gaskin, PhD , Department of African American Studies, University of Maryland at College Park, College Park, MD
Christine Spencer, ScD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Patrick Richard, MA , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Gerard Anderson, PhD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Neil Powe, MD, MPH, MBA , San Francisco General Hospital, University of California San Francisco, San Francisco, CA
Thomas A. LaVeist, PhD , Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Research objective: This study examines whether minority patients compared to white patients disproportionately use low quality hospitals.

Study Design: We computed hospital level composite quality scores using the AHRQ inpatient quality indicators (IQIs) and patient safety indicators (PSIs). We computed the average hospital quality used by each race/ethnic group (whites, blacks, Hispanics and Asians). Also, we identified hospitals ranked in bottom 20 percentile according to their composite quality scores. We computed the percentages of white, black, Hispanic and Asian discharges in these low performing hospitals.

Population Studied: We used 2001-2003 state inpatient discharge (SID) data from 11 states: AZ, CO, FL, IA, MA, MD, MI, NC, NJ, NY, and WI, and 2000-2002 SID data from PA. These states were selected because they report patients' race and Hispanic origin, permit researchers to use the hospital identifiers, and collect all the data elements required to compute the AHRQ IQIs and PSIs.

Principal Findings: Asian and black patients were more likely to use hospitals with poorer composite quality scores than white and Hispanic patients. All three minority groups were more likely to use hospitals in the bottom 20 percent of hospitals ranked according to their composite IQI and PSI scores.

Conclusions: Racial and ethnic disparities in hospital care are in part due to quality differences across hospitals.

Implications for Policy, Delivery or Practice: Interventions designed to reduce disparities in quality of hospital care should focus on low quality hospitals that serve high percentages of minority patients.

Learning Objectives:
Attendees will learn - Where minority patients are seeking hospital care What quality care patients are receiving in hospitals serving high volumes of minority patients The characteristics of hospitals providing low quality care.

Keywords: Health Disparities, Hospitals

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Medical Care Poster Session: Ethnic & Racial Disparities
See more of: Medical Care