martes, 26 de noviembre de 2013

Black patients more likely than whites... [Health Aff (Millwood). 2013] - PubMed - NCBI

Black patients more likely than whites... [Health Aff (Millwood). 2013] - PubMed - NCBI

2013 Jun;32(6):1046-53. doi: 10.1377/hlthaff.2011.1365.

Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.

Source

Division of Minimally Invasive Surgery, University of Michigan, Ann Arbor, Michigan, USA. jdimick@med.umich.edu

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.

KEYWORDS:

Access To Care, Disparities, Minority Health, Quality Of Care

Comment in


PMID:
23733978
[PubMed - in process]

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