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Minorities, Whites get equal care in
Hospitals
Newswise — A University of Maryland study of whether people
receive different quality of hospital care
because of their race or ethnicity found
that when whites and minorities are admitted
to a hospital for the same reason, they
receive the same quality care in that
hospital.
The study led by Darrell Gaskin, health economist in the
University of Maryland’s department of
African-American Studies, appears in the
March 11 issue of Health Affairs.
The study of 1841 hospitals in 13 states compares the quality of
treatment for blacks, Hispanics and Asians
to that of whites over a broad range of
services. It found that only a few hospitals
provide lower quality care to minorities
than to whites.
“The good news,” said Gaskin, “is that if you come to the
hospital for care, you’re probably getting
the same quality as everyone else in that
hospital.”
The study also may help pinpoint where improvements need to be
made to reduce the significant health care
disparities that are known to exist because
of race, ethnicity and income.
“Our study confirms that all patients in low performing hospitals
are at higher risk for mortality and
complications. We need to focus on improving
those low performers as opposed to hospitals
nationwide,” Gaskin said.
“Our results also suggest that we need to look more carefully at
other areas to find where disparities are
originating, such as getting access to the
good hospitals in the first place.”
Surprised at Findings
Gaskin admits he was surprised at the
results of the three-year study. Earlier
studies that looked at only a few specific
conditions, such as cardiac care, and used
general estimating equations, have shown
quality differences based on race.
What made this study different, Gaskin said, is that “we compared
a broader range of services and directly
compared hospital-specific quality
indicators for racial and ethnic groups.
"We examined rates of mortality and complications – whether
something bad happened in the hospital
because of the care.”
Gaskin’s group looked at hospitals in 13 states that report
patients’ race and that collect the specific
data the researchers needed to compute
quality measures.
Forty-four percent of the U.S. population live in these states,
with 36 percent of Asians, about 50 percent
of Hispanics, 46 percent of African
Americans and more than 44 percent of whites
residing in the areas studied.
The study covered more than 45 percent of urban hospitals and 28
percent of rural hospitals.
“The findings indicate that the systems in place in the hospitals
do work to deliver equal quality to patients
in that same hospital. It’s difficult for
one person’s bias to make a difference in
treatment that would show in mortality
rates,” Gaskin said.
Gaskin is now working on a study to examine minorities’ access to
quality medical care, particularly how
primary care affects equal access.
“We have a tremendous problem with minorities, especially blacks
and Asians, getting access to the good
hospitals or being referred for care when it
could make the most difference. The access
problem isn’t going to be solved in the
hospital. It has to be solved in
communities.”
Gaskin’s co-authors on the study were: Christine Spencer,
University of Baltimore; Patrick Richard,
University of California, Berkeley; Gerard
F. Anderson, Thomas A. Laveist, Johns
Hopkins Bloomberg School of Public Health;
Neil R. Powe, Johns Hopkins Medical
Institutions. The study was funded by a
grant from the Commonwealth Fund.
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