Relationship between patient demographics and hospital medical technology

Efforts to improve the quality of health care in the United States have led many hospitals to advocate using high-technology services. Particularly, there has been a rapid growth of diagnostic imaging services, such as magnetic resonance imaging (MRI) and computed tomography (CT), over the past decade. However, access to high technology hospitals might not be uniform across different patient groups. Prior studies suggest that racial/ethnic minorities and vulnerable population have lower access to a variety of health care. A retrospective, longitudinal study during 1998-2003. Data sources include the Healthcare Cost and Utilization Project (HCUP)'s Nationwide Inpatient Sample (NIS) and the American Hospital Association (AHA)'s Annual Survey Data. Hospital medical technology is represented as CT scanner, PET scanner, MRI, diagnostics radiation facility, and level 1 trauma center. Patient demographic and socioeconomic characteristics include race/ethnicity, expected primary payer, neighborhood income, age, and gender. A mixed-effects model is used to incorporate both fixed and random effects, and random effects are to vary according to different state. This study finds that a higher proportion of minority (Black and Hispanic) and Medicaid patients is associated with a decrease in the number of hospital medical technology. A higher proportion of female patients is also related to a lower level of technology. However, neighborhood income is not significantly associated with the level of technology. The results of this study suggest that hospitals that serve an increasing proportion of racial/ethnic minorities and Medicaid patients may have reduced investment in the high medical technology. Policymakers must understand the differences in access to hospitals with different level of technology by various populations.