Journal article
Black Patients More Likely Than Whites To Undergo Surgery At Low-Quality Hospitals In Segregated Regions
Health Affairs, Vol.32(6), pp.1046-1053
06/2013
DOI: 10.1377/hlthaff.2011.1365
PMID: 23733978
Abstract
Research has shown that black patients more frequently undergo surgery at low-quality hospitals than do white patients. We assessed the extent to which living in racially segregated areas and living in geographic proximity to low-quality hospitals contribute to this disparity. Using national Medicare data for all patients who underwent one of three high-risk surgical procedures in 2005-08, we found that black patients actually tended to live closer to higher-quality hospitals than white patients did but were 25-58 percent more likely than whites to receive surgery at low-quality hospitals. Racial segregation was also a factor, with black patients in the most segregrated areas 41-96 percent more likely than white patients to undergo surgery at low-quality hospitals. To address these disparities, care navigators and public reporting of comparative quality could steer patients and their referring physicians to higher-quality hospitals, while quality improvement efforts could focus on improving outcomes for high-risk surgery at hospitals that disproportionately serve black patients. Unfortunately, existing policies such as pay-for-performance, bundled payments, and nonpayment for adverse events may divert resources and exacerbate these disparities.
Details
- Title: Subtitle
- Black Patients More Likely Than Whites To Undergo Surgery At Low-Quality Hospitals In Segregated Regions
- Creators
- Justin Dimick - Justin Dimick is an associate professor of surgery and chief of the Division of Minimally Invasive Surgery, University of Michigan, in Ann ArborJoel Ruhter - Joel Ruhter is a senior research analyst at ArborMetrix, in Ann ArborMary Vaughan Sarrazin - Mary Vaughan Sarrazin is director of the Data Management and Analysis Cores, Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, in IowaJohn D Birkmeyer - John D. Birkmeyer is the George D. Zuidema Professor of Surgery and director of the Center for Healthcare Outcomes and Policy at the University of Michigan
- Resource Type
- Journal article
- Publication Details
- Health Affairs, Vol.32(6), pp.1046-1053
- DOI
- 10.1377/hlthaff.2011.1365
- PMID
- 23733978
- NLM abbreviation
- Health Aff (Millwood)
- ISSN
- 0278-2715
- eISSN
- 2694-233X
- Language
- English
- Date published
- 06/2013
- Academic Unit
- Health Management and Policy; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984064195102771
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