Hospitals that serve few minorities have experienced a steady drop in patient deaths. But findings published in the American Thoracic Society’s (ATS) American Journal of Respiratory and Critical Care Medicine reveal that hospitals that serve a majority of minority patients in their intensive care units (ICUs) have seen no such improvements, ATS reports. Furthermore, the disparity is most apparent among critically ill Black patients.
For the study, researchers evaluated nearly 1.1 million patients hospitalized at more than 200 hospitals that participated in the telehealth platform provided by Philips Healthcare from 2006 to 2016. In addition, investigators looked at patients’ length of stay in the ICU and the hospital.
Researchers defined minority-serving hospitals as either facilities that cared for twice as many minority patients as expected based on the percentage of African Americans or Hispanics living in the region according to the U.S. Census or hospitals where more than 25% of ICU patients identified as Black or Hispanic.
Findings showed that during this 10-year period, nearly a third of critically ill Black and half of critically ill Latino patients were treated at only 14 of the surveyed hospitals. Researchers also found a 2% decline in ICU deaths at nonminority hospitals every year but observed no decline at minority hospitals after the first few years.
Scientists also noted that ICU and hospital stays were longer at minority hospitals than nonminority ones. In addition, African Americans treated at nonminority hospitals experienced a decline in mortality of 3% each year compared with no decline at minority hospitals.
To avoid bias, researchers accounted for such variables as age, gender, admission diagnosis, severity of illness and coexisting health problems. They learned that minority-serving hospitals were more likely to tend to younger and sicker patients.
Patients at minority hospitals also waited longer to be admitted to the ICU from the emergency room than those treated at nonminority-serving hospitals. (This led researchers to believe that differences in resources played a role in their study findings.)
“The observation that large numbers of critically ill minorities are cared for in poorer performing ICUs gives us an important target for focused research efforts and additional resources to help close the health care divide amongst different minorities in the United States,” said John Danzinger, MD, MPhil, an assistant professor of medicine at Harvard Medical School and the lead study author.
For related coverage, read “Minority Infants More Likely to Receive Poor Care in NICUs.”