Despite greater awareness of diversity and initiatives to provide equal health care, racial disparities still exist, according to two new studies published in JAMA. Racial minorities are less likely to receive certain types of care, such as appendectomies, heart bypass surgery, or basic tests and drugs for heart disease and diabetes. Moreover, minority patients are less likely to have surgical procedures performed at high-volume hospitals. One study found that clinical performance on Health Plan Employer and Data Information Set outcome measures was 6.8% to 14.4% lower for blacks enrolled in a Medicare health plan. The other study found that blacks were only 71% as likely as whites to receive an abdominal aortic aneurysm repair at a high-volume hospital and that Medicaid beneficiaries and patients without insurance consistently received surgical procedures at low-volume hospitals. Some of the reasons for the disparity in choice of hospitals, according to the study, may be a lack of patient understanding about the effect of volume on quality, inadequate transportation to high-volume hospitals, and the fact that physicians treating black patients are less likely to be board certified.
“Everyone wants to improve quality, but it’s difficult,” Clifford Y. Ko, MD, a co-author and professor of surgery at UCLA, told The Washington Post. “Not everyone can go to these high-volume places. I personally think that instead of identifying one out of however many hospitals that people should go to that might have good outcomes, we should try to improve care at all hospitals.”
