161012 Best practices of hospitals that serve minority and low income patients

Wednesday, November 7, 2007: 3:15 PM

Darrell Gaskin, PhD , Department of African American Studies, University of Maryland at College Park, College Park, MD
Thomas A. LaVeist, PhD , Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, 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
     
Research objective: This study identifies factors that facilitate (and barriers that hinder) the provision of high quality of care in hospitals that serve high volumes of minority and low income patients.

Study Design: We conducted a case study of 8 urban hospitals serving high volumes of minority and low income patients. These hospitals were selected from urban hospitals located in the following states: AZ, CO, FL, IA, MA, MD, MI, NC, NJ, NY, PA and WI. We used the volume of minority and low income patients, hospital location (urban) and size (> 100) to identify eligible hospitals from the case study. To rate the quality of care in each hospital, we computed hospital level composite quality scores using the AHRQ inpatient quality indicators (IQIs) and patient safety indicators (PSIs). We computed composite scores for each minority group and low income patients (Medicaid/self pay). We ranked hospitals based on their composite scores and selected 6 hospitals that were high performing for minority and low income patients and 2 hospitals that were low performing for minority and low income patients.

Population Studied: We interviewed the CEO, CFO, medical director, quality improvement officer and head of nursing at each hospital to discuss the challenges they face in providing high quality care to their minority and low income patients.

Preliminary Findings: Among hospitals that serve high volumes of minority and low income patients, high performers have longer tenured senior leadership, greater and more stable financial resources, greater flexibility with personnel and staff decision, and greater investment in information technology.

Conclusions: Hospitals that provide low quality care to minority and low income patients are under-resourced. These hospitals have fewer human and financial resources than their high performing counterparts.

Implications for Policy, Delivery or Practice: To improve care in low performing hospitals, federal state and local policymakers should provide greater resources to hospitals serving minority and low income patients.

Learning Objectives:
Attendees will learn - the challenges facing hospitals that serve high volumes of minority and low income patients. - the barriers to providing high quality care to minority and low income patients. - the factors association with providing high quality care - the best practices of high performing hospitals.

Keywords: Health Disparities, Minority Health

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: Ethnic & Racial Disparities: Hospital System Level Solutions
See more of: Medical Care