Do Minority Patients Use Lower Quality Hospitals?

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The Issue

Several studies have suggested that minorities often receive lower-quality care because they are more likely to be treated in lower-quality hospitals—meaning that racial and ethnic disparities are more related to variations in the quality of care across hospitals than to variations within hospitals. This Commonwealth Fund–supported study sought to test the hypothesis by investigating whether hospital quality is inversely associated with the proportion of minority patients served.


What the Study Found

The authors used three years' worth of inpatient discharge data from 11 states, as well as inpatient quality indicators and patient safety indicators from the federal Agency for Healthcare Research and Quality, to investigate whether black, Hispanic, and Asian patients use lower-quality hospitals. They found that the association between the proportion of minority patients and hospital quality depended on how quality is assessed, and that it varied by race and ethnicity.

Hospitals that serve many Hispanics, for example, performed well on most of the measures of patient safety. Hospitals that serve higher percentages of all three minority groups had lower quality for one just measure of safety: cases of postoperative sepsis. 


Conclusions

"Our analysis indicates that it is incorrect to generalize that minorities use lower quality hospitals," the authors write. "Analysts and policymakers should be cautious when making generalizations about the overall service quality of hospitals that treat minority patients."

Publication Details

Publication Date: December 19, 2011
Authors: Gerard Anderson, Darrell J. Gaskin, Ph.D., Christine S. Spencer, Sc.D., Patrick Richard, Ph.D., Neil R. Powe, M.D., M.P.H., M.B.A., and Thomas A. LaVeist, Ph.D.
Summary Writer: Martha Hostetter
Citation:
D. J. Gaskin, C. S. Spencer, P. Richard et al., "Do Minority Patients Use Lower Quality Hospitals?" Inquiry, Fall 2011 48(3):209–20.
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