Outcomes for Whites and Blacks at Hospitals That Disproportionately Care for Black Medicare Beneficiaries

Q: What does this research mean for the field?

Hospitals with a high proportion of Black patients have worse mortality outcomes for both their White and Black elderly patients across common medical conditions compared to other hospitals. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Lenny López; Ashish K. Jha

doi:10.1111/j.1475-6773.2012.01445.x

July 20, 2012Health Services ResearchOpen Access

Outcomes for Whites and Blacks at Hospitals That Disproportionately Care for Black Medicare Beneficiaries

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Why the study?

Does admission to black-serving hospitals affect 30- and 90-day mortality in elderly Medicare beneficiaries with AMI, CHF, or pneumonia compared to nonblack-serving hospitals?

Key Points

To determine whether hospitals that disproportionately care for Black Medicare beneficiaries have worse 30-day and 90-day mortality rates for common medical conditions.
Analyzed the 2007 100% Medicare claims database for patients admitted with acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia.
Ranked all hospitals nationally by the proportion of discharged Black patients, defining the top 10% as Black-serving hospitals.
Calculated and compared race-specific, risk-adjusted 30-day and 90-day mortality rates while controlling for hospital-level characteristics.
At 30 days, Black-serving hospitals had higher mortality for pneumonia, lower mortality for CHF, and similar mortality for AMI compared with non-Black-serving hospitals.
At 90 days, Black-serving hospitals exhibited higher mortality for both AMI and pneumonia, alongside comparable mortality for CHF.
Both White and Black patients had worse outcomes at Black-serving hospitals, with White patients experiencing higher 90-day mortality across all three conditions.

Structured PICO

Does admission to black-serving hospitals affect 30- and 90-day mortality in elderly Medicare beneficiaries with AMI, CHF, or pneumonia compared to nonblack-serving hospitals?

P

Population

White and black elderly Medicare beneficiaries admitted for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia

I

Intervention

Admission to black-serving hospitals (defined as the top 10 percent of hospitals ranked by proportion of discharged black patients)

C

Comparator

Admission to nonblack-serving hospitals

O

Outcome

30- and 90-day mortality rateshard clinical

Hospitals that disproportionately care for black Medicare beneficiaries have worse 90-day mortality outcomes for both white and black patients admitted for AMI and pneumonia.

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Implication

Should not alter triage to black-serving hospitals; leaves open whether differences reflect quality, selection, or unmeasured factors.

Abstract

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Discussion

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Cite This Study

López et al. (2012) studied this question.

synapsesocial.com/papers/6a1be26b27b545b111a92924 https://doi.org/10.1111/j.1475-6773.2012.01445.x

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Outcomes for Whites and Blacks at Hospitals That Disproportionately Care for Black Medicare Beneficiaries

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Outcomes for Whites and Blacks at Hospitals That Disproportionately Care for Black Medicare Beneficiaries

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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