October 6, 2011
Study: Worst Hospitals Treat More Minorities
The nation’s hospitals with the lowest-quality care and highest costs treat more than twice as many elderly minority and poor patients than the best hospitals, according to a study published in the journal Health Affairs.
For the study, researchers at the Harvard School of Public Health examined the link between quality care, cost and types of patients at about 32,000 hospitals nationwide. Researchers then identified 122 “best” hospitals (those with the highest quality care and lowest cost rates) and 178 “worst” hospitals (those with the lowest quality care and highest cost rates).
The best hospitals were typically nonprofit institutions located in the northeast. (Many boasted cardiac intensive care units and a higher proportion of nurses.) The worst hospitals were usually small, for-profit or public and located in the South.
Researchers found that the worst hospitals treated twice the proportion of elderly minority and poor patients. What’s more, elderly African Americans constituted nearly 15 percent of patients in the worst hospitals compared with 6.8 percent of patients in the best hospitals. In addition, findings showed these patients were more likely to die of certain conditions, such as heart attacks and pneumonia.
What this means for poor and minority patients who use the worst hospitals, scientists cautioned, is that in 2013, when certain health care reform rules kick in, there’ll be significant problems. One of these new rules implements a national value-based purchasing system. With this system, the federal government will grant higher payments to high-quality hospitals that meet standards and cut payments to hospitals that fail to meet or improve their standards.
This means that many of the already disadvantaged hospitals will not do well in this environment and that patients will suffer, said Ashish Jha, an associate professor of health policy at the Harvard School of Public Health, and lead study author. “While value-based purchasing is well-intended, many hospitals that disproportionately care for minorities and the poor will fare poorly because they will have to improve quality to avoid financial penalties in an environment where overall payment rates are declining,” Jha said.
In order to avoid inadvertently making health care disparities worse in the quest to promote quality and efficiency, medical professionals will have to keep close track, Jha added.
This is why lawmakers are paying special attention to the health disparities minorities face. U.S. Representative Barbara Lee (D–Calif.) introduced the Health Equity and Accountability Act of 2011, a bill that seeks to eliminate racial and ethnic health disparities.
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